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BMD 430 FINAL EXAM

front 1

Which of the following are the two main keys to immune system function?
A) Memory and tolerance
B) Recognition and response
C) Specificity and diversity
D) Activation and suppression

back 1

B) Recognition and response

front 2

Primary lymphoid tissues are:
A) Sites where mature lymphocytes encounter antigens
B) Sites of development and maturation of lymphoid cells
C) Only the spleen and lymph nodes
D) Involved in antigen presentation to T cells

back 2

B) Sites of development and maturation of lymphoid cells

front 3

Which of the following activates the classical complement pathway?
A) Lipopolysaccharides (LPS)
B) Mannose-binding lectin
C) IgG and IgM antibodies
D) Cytokines

back 3

C) IgG and IgM antibodies

front 4

Which of the following is a characteristic of innate immunity?
A) Highly specific response to antigens
B) Generates memory after first exposure
C) Fast response but less specific
D) Receptors are generated through gene segment recombination

back 4

C) Fast response but less specific

front 5

Which of the following cells are of myeloid origin and generally part of the innate immune system?
A) B cells and T cells
B) NK cells and dendritic cells
C) Macrophages and neutrophils
D) Plasma cells and cytotoxic T cells

back 5

C) Macrophages and neutrophils

front 6

MHC class II molecules present:
A) Endogenous antigens to CD8+ T cells
B) Exogenous antigens to CD4+ T cells
C) Self-antigens to NK cells
D) Lipid antigens to B cells

back 6

B) Exogenous antigens to CD4+ T cells

front 7

Which of the following is not an outcome of complement activation?
A) Opsonization
B) Inflammation
C) Lysis
D) Antibody hypermutation

back 7

D) Antibody hypermutation

front 8

Germ-line encoded receptors are characteristic of:
A) Adaptive immunity
B) Innate immunity
C) Memory B cells
D) Somatic hypermutation

back 8

B) Innate immunity

front 9

Which cytokine is pro-inflammatory?
A) IL-10
B) TGF-β
C) IL-1β
D) IL-4

back 9

C) IL-1β

front 10

Which of the following is an effector function of antibodies?
A) Rolling
B) Opsonization
C) Diapedesis
D) T cell licensing

back 10

B) Opsonization

front 11

Briefly distinguish between primary and secondary lymphoid tissues and provide an example of each.

back 11

Primary: site of lymphocyte development/maturation (ex: bone marrow, thymus).
Secondary: site where mature lymphocytes encounter antigen (ex: spleen, lymph nodes).

front 12

list the three major functions of the innate immune system.

back 12

Physical/chemical barriers, cellular response to infection, activation of adaptive immunity.

front 13

Define an epitope and explain the difference between a sequential epitope and a conformational epitope.

back 13

Epitope: antigen region recognized by antibody or T cell.
Sequential: linear amino acid sequence.
Conformational: non-linear amino acids brought together by 3D folding.

front 14

What are the four stages of leukocyte trafficking?

back 14

Rolling → Activation → Firm adhesion → Diapedesis.

front 15

List the three signals in the three-signal hypothesis for T cell activation and the molecules involved in each.

back 15

Signal 1: TCR-MHC/peptide interaction.
Signal 2: Costimulation (CD28-CD80/86).
Signal 3: Cytokine signaling (cytokine binds receptor on T cell)

front 16

What is meant by MHC restriction?

back 16

T cells can only recognize antigens presented on self MHC molecules.

front 17

Explain the role of RAG1/2 in B and T cell receptor development.

back 17

  • RAG1/2 recombines gene segments (VDJ recombination) to generate diverse B/T cell receptors.

front 18

Distinguish between monoclonal and polyclonal antibodies.

back 18

Monoclonal: single epitope specificity.
Polyclonal: multiple epitopes on same antigen.

front 19

A patient presents with a bacterial infection. Explain how the innate immune system recognizes the pathogen and initiates a response, including complement activation.

back 19

Innate immune cells recognize PAMPs via PRRs, trigger phagocytosis, release cytokines, and activate complement (opsonization, inflammation, lysis).

front 20

During a secondary infection, why does the adaptive immune response increase compared to the primary response, whereas the innate immune response remains the same?

back 20

Adaptive immunity has memory cells → faster, stronger response. Innate immunity has no memory → response similar each time.

front 21

A researcher is designing a monoclonal antibody to target a specific epitope on a viral protein. Explain why a monoclonal antibody is preferred over a polyclonal antibody for this application.

back 21

Monoclonal antibody targets a single epitope → precise, reproducible, less off-target effects.

front 22

Explain the process by which a dendritic cell activates a naive cytotoxic CD8⁺ T cell, including the role of cross-presentation.

back 22

DC processes antigens → presents on MHC I (endogenous) or via cross-presentation → TCR recognizes antigen-MHC I → co-stimulation + cytokines → CD8⁺ differentiation into CTLs.

front 23

A patient has a mutation preventing proper function of CD28 on T cells. Predict the impact on T cell activation according to the three-signal hypothesis.

back 23

Without CD28, costimulatory signal missing → T cells cannot fully activate → impaired adaptive response.

front 24

Describe how a checkpoint inhibitor like ipilimumab enhances T cell responses in cancer therapy.

back 24

Ipilimumab blocks CTLA-4 → prevents inhibition of CD28 → T cells remain active → enhanced anti-tumor immunity.

front 25

Which antibody effector function causes pathogens to clump together, making them easier to clear?

A. Neutralization
B. Agglutination
C. ADCC
D. Degranulation

back 25

B. Agglutination

front 26

Which function describes antibodies coating a pathogen to enhance phagocytosis?

A. Complement fixation
B. Opsonization
C. Neutralization
D. Agglutination

back 26

B. Opsonization

front 27

Which effector function prevents viruses and toxins from binding to host cells?

A. Neutralization
B. ADCC
C. Opsonization
D. Complement fixation

back 27

A. Neutralization

front 28

Which antibody isotype is most effective at initiating the classical complement pathway?

A. IgA
B. IgE
C. IgM
D. IgD

back 28

C. IgM

front 29

Which process requires NK cells binding to the Fc region of IgG-coated target cells?

A. Opsonization
B. Complement fixation
C. ADCC
D. Neutralization

back 29

C. ADCC

front 30

Which effector function is triggered when IgE on mast cells becomes cross-linked by an allergen?

A. Neutralization
B. Degranulation
C. Agglutination
D. Complement fixation

back 30

B. Degranulation

front 31

Which antibody function leads to the formation of the membrane attack complex (MAC)?

A. Opsonization
B. Complement fixation
C. Neutralization
D. ADCC

back 31

B. Complement fixation

front 32

Which antibody function is MOST directly associated with protection against helminths (parasites)?

A. ADCC
B. Degranulation via IgE
C. Neutralization
D. Agglutination

back 32

B. Degranulation via IgE

front 33

Which antibody function enhances pathogen clearance specifically by facilitating ingestion by macrophages and neutrophils?

A. Neutralization
B. Opsonization
C. ADCC
D. Degranulation

back 33

B. Opsonization

front 34

Which function of antibodies does not require phagocytic cells?

A. Opsonization
B. Agglutination
C. Neutralization
D. ADCC

back 34

C. Neutralization

front 35

Which statement best distinguishes a monoclonal antibody from a polyclonal antibody?

A. Monoclonal antibodies bind multiple epitopes, while polyclonal antibodies bind only one epitope.
B. Monoclonal antibodies come from multiple B-cell clones, while polyclonal antibodies come from a single B-cell clone.
C. Monoclonal antibodies recognize a single epitope, while polyclonal antibodies recognize many epitopes on the same antigen.
D. Polyclonal antibodies are produced only in vitro, while monoclonal antibodies are produced only in vivo.

back 35

C. Monoclonal antibodies recognize a single epitope, while polyclonal antibodies recognize many epitopes on the same antigen.

front 36

Polyclonal antibodies are best described as:

A. Identical antibodies produced in hybridoma culture.
B. A mixture of antibodies produced by several B-cell clones against different epitopes.
C. Engineered antibodies with reduced immunogenicity.
D. Antibodies that bind only intracellular proteins.

back 36

B. A mixture of antibodies produced by several B-cell clones against different epitopes.

front 37

The endogenous antigen pathway results in antigen presentation on which molecule?

A. MHC I
B. MHC II
C. CD40
D. BCR

back 37

A. MHC I

front 38

Which type of antigen is processed through the endogenous pathway?

A. Extracellular bacteria
B. Environmental allergens
C. Intracellular proteins such as viral antigens
D. Helminths

back 38

C. Intracellular proteins such as viral antigens

front 39

Cross-presentation allows dendritic cells to:

A. Present endogenous antigens on MHC II only.
B. Present exogenous antigens on MHC I to activate CD8⁺ T cells.
C. Produce antibodies against multiple epitopes.
D. Present lipid antigens through CD1.

back 39

B. Present exogenous antigens on MHC I to activate CD8⁺ T cells

front 40

Activation of naïve CD8⁺ T cells requires antigen presented on:

A. MHC II
B. CD40
C. MHC I
D. TLR4

back 40

C. MHC I

front 41

Which of the following provides the co-stimulatory signal required for T-cell activation?

A. TCR binding to antigen
B. CD40 binding to CD40L
C. B7 on dendritic cells binding to CD28 on T cells
D. IL-12 secretion

back 41

C. B7 on dendritic cells binding to CD28 on T cells

front 42

Which cytokine produced by dendritic cells is essential for CD8⁺ T-cell activation and differentiation into CTLs?

A. IL-4
B. IL-12
C. IL-10
D. IL-17

back 42

B. IL-12

front 43

Which interaction is responsible for “licensing” dendritic cells, enhancing their ability to activate CD8⁺ T cells?

A. B7–CD28
B. CD40–CD40L
C. TCR–MHC II
D. IL-12–IL-12 receptor

back 43

B. CD40–CD40L

front 44

Presentation of exogenous antigens to naïve CD4⁺ T cells primarily occurs through:

A. MHC I
B. MHC II
C. Fc receptors
D. Complement receptors

back 44

B. MHC II

front 45

What is the primary function of a checkpoint inhibitor in cancer immunotherapy?

A. To suppress T-cell activation
B. To inhibit molecules that normally inhibit T-cell activation
C. To activate B cells to produce more antibodies
D. To block antigen presentation on dendritic cells

back 45

B. To inhibit molecules that normally inhibit T-cell activation

front 46

Which T-cell molecule is targeted by the checkpoint inhibitor ipilimumab?

A. CD28
B. PD-1
C. CTLA-4
D. CD40L

back 46

C. CTLA-4

front 47

CTLA-4 normally functions by:

A. Enhancing T-cell co-stimulation
B. Blocking CD28 from binding to CD80/86
C. Increasing cytokine secretion
D. Presenting antigen to T cells

back 47

B. Blocking CD28 from binding to CD80/86

front 48

Which statement best describes the mechanism of checkpoint inhibition?

A. It increases inhibitory signaling to prevent autoimmunity.
B. It blocks inhibitory receptors, removing the “brake” on T-cell activation.
C. It prevents T cells from binding to APCs.
D. It replaces MHC molecules on dendritic cells.

back 48

B. It blocks inhibitory receptors, removing the “brake” on T-cell activation.

front 49

When CTLA-4 is active on a T cell, what is the result?

A. Enhanced co-stimulation through CD28
B. Strong activation of cytotoxic T lymphocytes
C. Suppressed T-cell activation
D. Increased antibody production

back 49

C. Suppressed T-cell activation

front 50

Ipilimumab enhances antitumor immunity by:

A. Blocking PD-L1
B. Blocking CTLA-4 so CD28 can bind CD80/86
C. Inhibiting dendritic cell maturation
D. Stimulating IL-10 production

back 50

B. Blocking CTLA-4 so CD28 can bind CD80/86

front 51

Which of the following is a myeloid cell that functions primarily in the innate immune response?

A. B cell
B. T cell
C. Neutrophil
D. NK cell

back 51

C. Neutrophil6

front 52

Which cell type is of lymphoid origin but functions in the innate immune system?

A. NK cell
B. Basophil
C. Macrophage
D. Dendritic cell

back 52

A. NK cell

front 53

B cells are classified as:

A. Myeloid, innate
B. Lymphoid, innate
C. Myeloid, adaptive
D. Lymphoid, adaptive

back 53

D. Lymphoid, adaptive

front 54

Which immune cell is of myeloid origin and responsible for allergic inflammation?

A. Basophil
B. NK cell
C. T cell
D. B cell

back 54

A. Basophil

front 55

Which cell is myeloid-derived, part of the innate system, and acts as a key phagocyte?

A. T cell
B. B cell
C. Macrophage
D. NK cell

back 55

C. Macrophage

front 56

Dendritic cells are best described as:

A. Myeloid, innate cells that also activate adaptive immunity
B. Lymphoid, innate cells that produce antibodies
C. Myeloid, adaptive cells that kill viruses
D. Lymphoid, adaptive cells that phagocytose bacteria

back 56

A. Myeloid, innate cells that also activate adaptive immunity

front 57

Which of the following is lymphoid-derived and functions in the adaptive immune system?

A. Basophil
B. NK cell
C. Neutrophil
D. T cell

back 57

D. T cell

front 58

Which of the following activates the classical complement pathway?

A. IgG and IgM antibodies bound to antigen
B. Mannose-binding lectin binding to pathogen surfaces
C. Spontaneous hydrolysis of C3
D. NK cells

back 58

A. IgG and IgM antibodies bound to antigen

front 59

The alternative complement pathway is primarily activated by:

A. IgA antibodies
B. PAMPs such as LPS and spontaneous hydrolysis of C3
C. Mannose-binding lectin
D. T-cell receptor signaling

back 59

B. PAMPs such as LPS and spontaneous hydrolysis of C3

front 60

The mannose-binding lectin (MBL) pathway is triggered when:

A. Antibodies bind to antigen
B. MBL binds to mannose residues on microbial surfaces
C. C3 spontaneously hydrolyzes on host cells
D. Complement receptor 1 (CR1) is engaged

back 60

B. MBL binds to mannose residues on microbial surfaces

front 61

Which statement about the alternative complement pathway is true?

A. It requires prior antibody binding to activate
B. Spontaneous C3 hydrolysis occurs, but full activation only happens on non-self surfaces
C. It is initiated by mannose residues on pathogens
D. It exclusively targets self-cells for clearance

back 61

B. Spontaneous C3 hydrolysis occurs, but full activation only happens on non-self surfaces

front 62

According to clonal selection theory, what occurs after a B or T cell receptor binds its specific antigen?

A. Immediate apoptosis
B. Clonal expansion of the activated lymphocyte
C. Differentiation into NK cells
D. Secretion of complement proteins

back 62

B. Clonal expansion of the activated lymphocyte

front 63

One major tenet of clonal selection theory is:

A. All B and T cells are pre-activated at birth
B. Individual B and T cell receptors are generated by gene segment rearrangement
C. Antigen recognition is unnecessary for lymphocyte activation
D. Only macrophages undergo clonal expansion

back 63

B. Individual B and T cell receptors are generated by gene segment rearrangement

front 64

Clonal selection theory predicts that:

A. Lymphocytes with receptors that do not bind antigen are eliminated or remain inactive
B. All lymphocytes are identical
C. Activation of T cells does not require receptor engagement
D. Antibodies are produced before antigen exposure

back 64

A. Lymphocytes with receptors that do not bind antigen are eliminated or remain inactive