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Summer Immuno Lecture 7

front 1

A naive lymphocyte first recognizes its specific antigen and begins adaptive immune activation. Where does this recognition phase occur?
A. Primary lymphoid organs
B. Secondary lymphoid organs
C. Peripheral infected tissue
D. Bone marrow sinusoids

back 1

B. Secondary lymphoid organs

front 2

Which set contains only secondary lymphoid organs?
A. Thymus, spleen, MALT
B. Bone marrow, thymus, spleen
C. Lymph nodes, thymus, MALT
D. Lymph nodes, spleen, MALT

back 2

D. Lymph nodes, spleen, MALT

front 3

Which organs are classified as primary lymphoid organs?
A. Bone marrow and thymus
B. Spleen and thymus
C. Lymph nodes and MALT
D. Cortex and paracortex

back 3

A. Bone marrow and thymus

front 4

A patient has impaired lymphoid follicle formation. Which immune structures would most directly share this abnormality?
A. Primary lymphoid organs
B. All lymphatic vessels
C. Secondary lymphoid organs
D. All inflamed tissues

back 4

C. Secondary lymphoid organs

front 5

The common anatomical structure shared by secondary lymphoid organs is which of the following?
A. High endothelial venules
B. Lymphoid follicles
C. Hassall corpuscles
D. Red pulp cords

back 5

B. Lymphoid follicles

front 6

Lymphoid follicles begin as loose networks of which cell type?
A. Conventional dendritic cells
B. Medullary epithelial cells
C. Paracortical macrophages
D. Follicular dendritic cells

back 6

D. Follicular dendritic cells

front 7

Early lymphoid follicles form in regions especially rich in which lymphocyte population?
A. B cells
B. T cells
C. NK cells
D. Plasma cells

back 7

A. B cells

front 8

Follicular dendritic cells are already present by which developmental period?
A. First trimester
B. Birth
C. Second trimester
D. Early infancy

back 8

C. Second trimester

front 9

Which cell type displays antigen primarily to B cells?
A. Macrophages
B. Follicular dendritic cells
C. Conventional dendritic APCs
D. Thymic epithelial cells

back 9

B. Follicular dendritic cells

front 10

Which cell type presents antigen primarily to T cells?
A. Follicular dendritic cells
B. Conventional dendritic APCs
C. Marginal-zone B cells
D. Stromal reticular cells

back 10

B. Conventional dendritic APCs

front 11

A follicular dendritic cell binds antigen coated with complement fragments. Which receptor function explains this?
A. BCR crosslinking receptors
B. Complement fragment binding
C. TCR antigen presentation
D. Fc-independent antigen uptake

back 11

B. Complement fragment binding

front 12

A follicular dendritic cell bind complement-opsonized antigen because they express receptors for which material?
A. Fc regions
B. Cytokine gradients
C. Complement fragments
D. Chemokine ligands

back 12

C. Complement fragments

front 13

A follicular dendritic cell holds many antigen molecules very close together. What B-cell event does this promote?
A. TCR editing
B. FasL signaling
C. BCR crosslinking
D. MHC I loading

back 13

C. BCR crosslinking

front 14

Follicular dendritic cells can also bind immune complexes using receptors for which antibody region?
A. Fab region
B. J chain
C. Variable region
D. Fc region

back 14

D. Fc region

front 15

A follicular dendritic cell attracts and activates B cells, leading to intense B-cell proliferation. Over time, this active follicle becomes what?
A. Red pulp
B. Germinal center
C. Thymic cortex
D. Paracortical cord

back 15

B. Germinal center

front 16

A germinal center is best described as which structure?
A. Active secondary lymphoid follicle
B. Primary lymphoid maturation site
C. T-cell deletion region
D. Macrophage-rich venous sinus

back 16

A. Active secondary lymphoid follicle

front 17

Before adaptive immunity responds effectively to infection, which system must first detect danger?
A. Humoral system
B. Complement system
C. Innate system
D. Lymphatic system

back 17

C. Innate system

front 18

B cells proliferating in germinal centers become fragile. Which cells rescue them from apoptosis?
A. Helper T cells
B. NK cells
C. Neutrophils
D. Follicular macrophages

back 18

A. Helper T cells

front 19

Which secondary lymphoid organ lacks high endothelial venules?
A. MALT
B. Lymph node
C. Peyer patch
D. Spleen

back 19

D. Spleen

front 20

High endothelial venules serve primarily as a doorway for which cells?
A. Neutrophils and eosinophils
B. B and T cells
C. Monocytes and basophils
D. Plasma cells and platelets

back 20

B. B and T cells

front 21

High endothelial venules allow lymphocytes to enter secondary lymphoid organs from which compartment?
A. Blood
B. Bone marrow
C. Germinal centers
D. Efferent lymph

back 21

A. Blood

front 22

High endothelial venules are regions within which vessel type?
A. Arteriole
B. Capillary
C. Venule
D. Lymphatic duct

back 22

C. Venule

front 23

In a lymph node, high endothelial venules are located in which region?
A. Cortex
B. Medulla
C. Paracortex
D. Capsule

back 23

C. Paracortex

front 24

In a lymph node, B cells mainly accumulate in which area?
A. Paracortex
B. Cortex
C. Medulla
D. Hilum

back 24

B. Cortex

front 25

In a lymph node, T cells mainly accumulate in which area?
A. Paracortex
B. Cortex
C. Follicle center
D. Subcapsular sinus

back 25

A. Paracortex

front 26

Conventional dendritic cells mainly accumulate in which lymph-node region?
A. Cortex
B. Medulla
C. Paracortex
D. Germinal center

back 26

C. Paracortex

front 27

Follicular dendritic cells are mainly located in which lymph-node region?
A. Paracortex
B. Cortex
C. Medulla
D. Hilum

back 27

B. Cortex

front 28

In lymph nodes, the B-cell area correlates with which dendritic cell location?
A. Conventional DCs in cortex
B. FDCs in cortex
C. FDCs in paracortex
D. Macrophages in paracortex

back 28

B. FDCs in cortex

front 29

In lymph nodes, the T-cell area correlates with which dendritic cell location?
A. FDCs in medulla
B. Macrophages in cortex
C. Conventional DCs in paracortex
D. B cells in sinuses

back 29

C. Conventional DCs in paracortex

front 30

Lymph-node sinus walls are carpeted with which immune cells?
A. Dendritic cells
B. Macrophages
C. Plasma cells
D. Eosinophils

back 30

B. Macrophages

front 31

Movement of immune cells within secondary lymphoid organs is coordinated by which signal type?
A. Chemokines
B. Antibodies
C. Perforins
D. Integrins only

back 31

A. Chemokines

front 32

Chemokines are best described as which type of cytokine?
A. Apoptotic cytokines
B. Chemoattractive cytokines
C. Cytotoxic cytokines
D. Complement-fixing cytokines

back 32

B. Chemoattractive cytokines

front 33

Follicular dendritic cells produce which chemokine to attract naive B cells?
A. CCR7
B. ICOSL
C. CXCR5
D. CXCL13

back 33

D. CXCL13

front 34

After a B cell finds its cognate antigen, what happens to its CXCL13 receptor expression?
A. It increases sharply
B. It remains unchanged
C. It downregulates
D. It switches to CD28

back 34

C. It downregulates

front 35

After recognizing cognate antigen, an activated B cell upregulates which chemokine receptor?
A. CXCL13
B. CCR7
C. ICOSL
D. B7

back 35

B. CCR7

front 36

CCR7 expression helps activated B cells migrate toward which region?
A. Medullary sinus
B. Thymic cortex
C. Blood-red pulp border
D. Cortex-paracortex border

back 36

D. Cortex-paracortex border

front 37

The cortex-paracortex border is important because it allows meeting between which cells?
A. B cells and T cells
B. NK cells and neutrophils
C. Macrophages and eosinophils
D. Plasma cells and platelets

back 37

A. B cells and T cells

front 38

Activated helper T cells downregulate signals keeping them in which region?
A. Cortex
B. Paracortex
C. Medulla
D. Red pulp

back 38

B. Paracortex

front 39

Activated helper T cells upregulate which receptor to meet activated B cells?
A. CCR7
B. CXCL13
C. CXCR5
D. ICOSL

back 39

C. CXCR5

front 40

CXCR5 expression helps helper T cells congregate with activated B cells at which site?
A. Medullary cord
B. Follicle border
C. Splenic red pulp
D. Efferent lymphatic

back 40

B. Follicle border

front 41

B cells require help from activated helper T cells. Activated helper T cells also require help from which cells?
A. Activated B cells
B. Resting macrophages
C. Naive neutrophils
D. Medullary thymocytes

back 41

A. Activated B cells

front 42

The reciprocal help between activated B cells and activated Th cells occurs through what mechanism?
A. Cell-cell contact
B. Antibody secretion only
C. Complement lysis
D. Cytokine diffusion only

back 42

A. Cell-cell contact

front 43

Which B-cell surface protein binds CD28 on helper T cells?
A. CCR7
B. ICOSL
C. B7
D. CXCL13

back 43

C. B7

front 44

Which B-cell surface protein binds ICOS on helper T cells?
A. B7
B. ICOSL
C. CCR7
D. CXCR5

back 44

B. ICOSL

front 45

Which helper T-cell protein binds B7 on the activated B-cell surface?
A. ICOS
B. CD28
C. CCR7
D. CXCR5

back 45

B. CD28

front 46

Which helper T-cell protein binds ICOSL on the activated B-cell surface?
A. CD28
B. CXCL13
C. CCR7
D. ICOS

back 46

D. ICOS

front 47

A defect prevents activated B cells from interacting with Th-cell CD28. Which B-cell molecule is most likely defective?
A. B7
B. CCR7
C. ICOSL
D. CXCL13

back 47

A. B7

front 48

A defect prevents activated B cells from interacting with Th-cell ICOS. Which B-cell molecule is most likely defective?
A. CXCR5
B. ICOSL
C. B7
D. CCR7

back 48

B. ICOSL

front 49

A patient has impaired complement deposition on antigen. Which FDC function would be most directly reduced?
A. Binding opsonized antigen
B. Producing IL-2
C. Presenting peptide to T cells
D. Activating thymic selection

back 49

A. Binding opsonized antigen

front 50

Which statement best captures secondary lymphoid organ function?
A. They produce immature lymphocytes
B. They delete autoreactive thymocytes
C. They support antigen recognition
D. They generate hematopoietic stem cells

back 50

C. They support antigen recognition

front 51

At the follicle border, an activated Th cell directly helps an activated B cell through which ligand-receptor pair?
A. ICOSL–ICOS
B. B7–CD28
C. CD40L–CD40
D. CXCL13–CXCR5

back 51

C. CD40L–CD40

front 52

During the B-cell/Th-cell “dance,” which molecule is provided by the helper T cell?
A. CD40L
B. B7
C. ICOSL
D. Antigen

back 52

A. CD40L

front 53

During the B-cell/Th-cell “dance,” which molecule is found on the B-cell surface and binds CD40L?
A. ICOS
B. CD28
C. CXCR5
D. CD40

back 53

D. CD40

front 54

Activated B cells provide which material to help helper T cells mature?
A. IL-17, IL-21, IL-23
B. Antigen, B7, ICOSL
C. CD40L, IL-2, FasL
D. Perforin, granzyme, IFN-gamma

back 54

B. Antigen, B7, ICOSL

front 55

A helper T cell becomes fully mature at the follicular border after contact with an activated B cell. What is it now called?
A. Th0 cell
B. Treg cell
C. Tfh cell
D. CTL cell

back 55

C. Tfh cell

front 56

Follicular helper T cells are licensed to rescue which fragile cell population?
A. Germinal-center B cells
B. Naive T cells
C. Marginal-zone macrophages
D. Follicular dendritic cells

back 56

A. Germinal-center B cells

front 57

A germinal-center B cell receives Tfh help and avoids apoptosis. Which later processes can Tfh cells support?
A. Chemotaxis and phagocytosis
B. Class switching and hypermutation
C. Necrosis and opsonization
D. Tolerance and anergy

back 57

B. Class switching and hypermutation

front 58

During affinity maturation, B cells with higher-affinity receptors gain an advantage by doing what?
A. Secreting more IL-12
B. Plucking more antigen
C. Blocking CD40 signaling
D. Losing class II MHC

back 58

B. Plucking more antigen

front 59

Higher-affinity B cells present more antigen to Tfh cells using which molecule?
A. Class II MHC
B. Class I MHC
C. CD40 ligand
D. TLR4 receptor

back 59

A. Class II MHC

front 60

In germinal centers, greater antigen presentation by high-affinity B cells causes what outcome?
A. Less Tfh help
B. Immediate necrosis
C. More Tfh help
D. Reduced proliferation

back 60

C. More Tfh help

front 61

Somatic hypermutation selects higher-affinity B cells because these cells receive more help from which cells?
A. NK cells
B. Tfh cells
C. Neutrophils
D. Eosinophils

back 61

B. Tfh cells

front 62

A killer T cell recognizes cognate antigen presented by dendritic cells in a lymph node. Where does activation occur?
A. Cortex
B. Medulla
C. Follicle
D. Paracortex

back 62

D. Paracortex

front 63

A lymph node draining an infected wound becomes enlarged. Which process contributes most directly?
A. Lymphocyte proliferation
B. Erythrocyte trapping
C. Platelet aggregation
D. Fibroblast calcification

back 63

A. Lymphocyte proliferation

front 64

In infected draining lymph nodes, medullary sinuses may become clogged by which cells?
A. Basophils
B. Eosinophils
C. Macrophages
D. Mast cells

back 64

C. Macrophages

front 65

Peyer patches are examples of which lymphoid tissue?
A. Thymic tissue
B. Red pulp
C. Bone marrow
D. MALT

back 65

D. MALT

front 66

Unlike lymph nodes, Peyer patches lack which structure?
A. Outgoing lymphatics
B. Incoming lymphatics
C. Germinal centers
D. B-cell follicles

back 66

B. Incoming lymphatics

front 67

Peyer patches still contain which drainage structure?
A. Outgoing lymphatics
B. Incoming lymphatics
C. Splenic sinusoids
D. Afferent arterioles

back 67

A. Outgoing lymphatics

front 68

Peyer patches are topped by which specialized epithelial cells?
A. Goblet cells
B. Paneth cells
C. Enteroendocrine cells
D. M cells

back 68

D. M cells

front 69

M cells over Peyer patches are not coated with which structures?
A. IgE and CD40
B. B7 and ICOSL
C. Mucus and villi
D. FasL and perforin

back 69

C. Mucus and villi

front 70

M cells sample material from which location?
A. Splenic blood
B. Intestinal lumen
C. Bone marrow
D. Medullary sinus

back 70

B. Intestinal lumen

front 71

M cells transport sampled intestinal material into which site?
A. Bloodstream
B. Thymic medulla
C. Red pulp
D. Underlying tissues

back 71

D. Underlying tissues

front 72

The spleen primarily functions as what type of filter?
A. Blood filter
B. Lymph filter
C. Mucus filter
D. Airway filter

back 72

A. Blood filter

front 73

Approximately what fraction of cardiac output enters the spleen?
A. 1%
B. 20%
C. 5%
D. 50%

back 73

C. 5%

front 74

The spleen screens circulating blood approximately every how long?
A. 5 minutes
B. 30 minutes
C. 6 hours
D. 1 day

back 74

B. 30 minutes

front 75

Compared with lymph nodes and Peyer patches, the spleen is less selective because everything enters from where?
A. Blood
B. Lymph
C. Mucus
D. Thymus

back 75

A. Blood

front 76

Which organs are selective about where B/T cells and antigens enter?
A. Spleen and thymus
B. Marrow and thymus
C. Spleen and marrow
D. Lymph nodes and Peyer patches

back 76

D. Lymph nodes and Peyer patches

front 77

In the spleen, T cells are temporarily retained in which region?
A. Marginal sinus
B. Red pulp
C. PALS
D. Trabeculae

back 77

C. PALS

front 78

In the spleen, B cells are found between which structures?
A. Red pulp and capsule
B. PALS and marginal sinuses
C. Thymus and medulla
D. Cortex and paracortex

back 78

B. PALS and marginal sinuses

front 79

The periarteriolar lymphocyte sheath mainly retains which cells?
A. T cells
B. B cells
C. Plasma cells
D. Macrophages

back 79

A. T cells

front 80

The spleen lacks lymphatics to transport dendritic cells from tissues. How does it compensate?
A. Uses thymic epithelial cells
B. Uses incoming M cells
C. Uses circulating neutrophils
D. Uses resident dendritic cells

back 80

D. Uses resident dendritic cells

front 81

In the spleen, resident dendritic cells take up antigens from invaders located where?
A. Mucus layer
B. Lymphatic fluid
C. Blood
D. Thymic cortex

back 81

C. Blood

front 82

Which organ is a main site where B cells can activate without Th-cell assistance?
A. Lymph node
B. Spleen
C. Thymus
D. Bone marrow

back 82

B. Spleen

front 83

B cells that can activate without Th-cell help in the spleen are called what?
A. Germinal-center B cells
B. Naive follicular B cells
C. Plasma memory cells
D. Marginal-zone B cells

back 83

D. Marginal-zone B cells

front 84

Marginal-zone B cells are stationed where they contact blood entering the spleen. Where is this?
A. Marginal sinuses
B. Red pulp cords
C. Splenic capsule
D. Central arteriole wall

back 84

A. Marginal sinuses

front 85

Secondary lymphoid organs are strategically positioned to intercept which threat?
A. Self-reactive thymocytes
B. Aging erythrocytes only
C. Invaders entering the body
D. Bone marrow precursors

back 85

C. Invaders entering the body

front 86

Secondary lymphoid organs provide environments that mobilize weapons appropriate to what?
A. Thymocyte selection stage
B. Likely invading organisms
C. Red-cell deformability
D. Platelet activation status

back 86

B. Likely invading organisms

front 87

The most important function of secondary lymphoid organs is bringing together which cells?
A. Platelets and erythrocytes
B. Mast cells and basophils
C. Fibroblasts and osteoblasts
D. Lymphocytes and APCs

back 87

D. Lymphocytes and APCs

front 88

Bringing lymphocytes and APCs together increases the probability of activating which immune system?
A. Adaptive immune system
B. Complement system
C. Coagulation system
D. Innate barrier system

back 88

A. Adaptive immune system

front 89

The process of B and T cells moving to specific locations is called what?
A. Chemotactic drift
B. Lymphocyte trafficking
C. Germinal rescue
D. Antigen plucking

back 89

B. Lymphocyte trafficking

front 90

Virgin and experienced lymphocytes differ mainly in which feature?
A. Nuclear membrane number
B. Immunoglobulin shape
C. Traffic patterns
D. Ribosomal density

back 90

C. Traffic patterns

front 91

Virgin T cells use which molecule to enter lymph nodes through HEVs?
A. L-selectin
B. αEβ7
C. ICOSL
D. FasL

back 91

A. L-selectin

front 92

L-selectin on virgin T cells binds which ligand on lymph-node HEVs?
A. MadCAM-1
B. ICOS
C. CD40
D. GlyCAM-1

back 92

D. GlyCAM-1

front 93

Virgin T cells use which integrin to enter Peyer patches and intestinal lymph nodes?
A. CD28
B. α4β7
C. CXCL13
D. CD40L

back 93

B. α4β7

front 94

α4β7 on virgin T cells binds which ligand on intestinal HEVs?
A. GlyCAM-1
B. Fas receptor
C. MadCAM-1
D. ICOSL

back 94

C. MadCAM-1

front 95

MadCAM-1 is expressed on HEVs in which sites?
A. Peyer patches, intestinal nodes
B. Thymus, bone marrow
C. Red pulp, splenic capsule
D. Skin, hepatic sinusoids

back 95

A. Peyer patches, intestinal nodes

front 96

Virgin T cells circulate through blood and lymph, spending about how long per loop?
A. 1 day
B. 1 week
C. 6 weeks
D. 30 minutes

back 96

A. 1 day

front 97

If a virgin T cell does not find cognate antigen, it dies after approximately how long?
A. 1 day
B. 30 minutes
C. 1 year
D. 6 weeks

back 97

D. 6 weeks

front 98

A virgin T cell failing to find cognate antigen eventually dies by what mechanism?
A. Necrosis
B. Pyroptosis
C. Apoptosis
D. Complement lysis

back 98

C. Apoptosis

front 99

Experienced T cells that have found cognate antigen have their travel passports become what?
A. Expanded
B. Deleted
C. Randomized
D. Restricted

back 99

D. Restricted

front 100

Experienced T cells express adhesion molecules based on what location?
A. Where they activated
B. Where they die
C. Where they circulate randomly
D. Where antibodies bind

back 100

A. Where they activated

front 101

A T cell activated in a Peyer patch will increase which adhesion molecule?
A. GlyCAM-1
B. CD40
C. α4β7
D. B7

back 101

C. α4β7

front 102

Increased α4β7 on Peyer-patch-activated T cells helps them do what?
A. Return to mucosal sites
B. Enter thymic cortex
C. Bind splenic red pulp
D. Block dendritic migration

back 102

A. Return to mucosal sites

front 103

Experienced T cells also carry “combat passports” that help them enter what sites?
A. Primary lymphoid organs
B. Sites of infection
C. Bone marrow niches
D. Thymic medulla

back 103

B. Sites of infection

front 104

Experienced mucosa-activated T cells express which integrin?
A. α4β7
B. MadCAM-1
C. L-selectin
D. αEβ7

back 104

D. αEβ7

front 105

αEβ7 helps experienced mucosal T cells enter which tissue environment?
A. Inflamed mucosa
B. Splenic capsule
C. Thymic cortex
D. Bone marrow

back 105

A. Inflamed mucosa

front 106

A defect in CD40L expression on activated Th cells would most directly impair which interaction?
A. B-cell CD40 activation
B. HEV entry into nodes
C. Antigen plucking by FDCs
D. M-cell sampling

back 106

A. B-cell CD40 activation

front 107

A B cell fails to provide B7 and ICOSL to a helper T cell. Which process is most directly impaired?
A. CTL granzyme release
B. Helper T-cell maturation
C. M-cell antigen transport
D. Splenic blood screening

back 107

B. Helper T-cell maturation

front 108

A high-affinity B cell outcompetes low-affinity B cells in a germinal center. Which mechanism best explains this?
A. Less antigen presentation
B. Better antigen plucking
C. Loss of class II MHC
D. Reduced Tfh contact

back 108

B. Better antigen plucking

front 109

A patient’s draining lymph node is swollen after cellulitis. Which combined mechanism best explains the swelling?
A. Lymphocyte loss, neutrophil apoptosis
B. Platelet trapping, RBC hemolysis
C. Lymphocyte growth, macrophage clogging
D. Fibrosis, thymocyte expansion

back 109

A. Lymphocyte loss, neutrophil apoptosis

front 110

A virgin T cell enters intestinal lymphoid tissue. Which receptor-ligand pair is most likely used?
A. CD40L–CD40
B. L-selectin–GlyCAM-1
C. α4β7–MadCAM-1
D. ICOS–ICOSL

back 110

C. α4β7–MadCAM-1

front 111

A virgin T cell enters a nonintestinal lymph node through HEVs. Which pair is most relevant?
A. αEβ7–mucosal ligand
B. α4β7–MadCAM-1
C. ICOS–ICOSL
D. L-selectin–GlyCAM-1

back 111

D. L-selectin–GlyCAM-1

front 112

A mucosa-activated experienced T cell leaves the lymphoid organ. Which change best predicts its future homing?
A. More α4β7 expression
B. Loss of all integrins
C. More splenic PALS binding
D. Less tissue selectivity

back 112

A. More α4β7 expression