Immunology for Pharmacists Solved Exam Questions
Course Introduction
Immunology for Pharmacists is a course designed to provide pharmacy students with a foundational understanding of the human immune system and its relevance to pharmacotherapy. The course covers key concepts such as innate and adaptive immunity, immune cell functions, hypersensitivity reactions, autoimmunity, immunodeficiency, and the immunological basis of vaccines. Emphasis is placed on the mechanisms of immune responses to pathogens, the impact of immunomodulatory drugs, and the pharmacological management of immune-related disorders. Through case studies and clinical examples, students will learn to apply immunological principles to patient care, drug development, and therapeutic decision-making in a pharmacy setting.
Recommended Textbook
Immunology for Pharmacy 1st Edition by Dennis Flaherty PhD
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26 Chapters
300 Verified Questions
300 Flashcards
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Page 2
Chapter 1: Cells and Organs of the Immune System
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Sample Questions
Q1) The __________________ serves as a filter to trap infections in the tissues.
A) Spleen
B) Thymus
C) Bone marrow
D) Lymph system
Answer: D
Q2) All T cells express which of the following CD markers?
A) CD3
B) CD4
C) CD8
D) CD16
Answer: A
Q3) Which of the following cells is important for killing virus-infected cells?
A) NK cells
B) Basophils
C) Monocytes
D) Plasma cells
Answer: A
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Chapter 2: Innate Immunity
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Q1) Cathelicidins perform which of the following functions?
I. Chemotaxis
II. Neutralization of endotoxins
III. Broad spectrum antimicrobial activity
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Answer: E
Q2) Toll-like receptors (TLRs) activate the adaptive immune system by stimulating production of:
A) Interleukin-1 (IL-1)
B) Interleukin-6 (IL-6)
C) Interleukin-12 (IL-12)
D) Tumor necrosis factor-alpha (TNF-a)
Answer: B
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Chapter 3: Immunogenicity and Antigenicity
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Sample Questions
Q1) Isoantigens found on red blood cells (RBCs) may lead to a hemolytic transfusion reaction because:
A) CD4<sup>+</sup> T cells and macrophages mediate an inflammatory response
B) Individuals have antibodies to the ABO antigens they do not express
C) CD8<sup>+</sup> T cells recognize the isoantigens as foreign and destroy the RBC
D) The isoantigens are metabolized to reactive metabolites that cause an allergic reaction
Answer: B
Q2) Which of the following would be considered the best immunogen?
A) Mannose
B) Viral DNA
C) Surface protein on a parasite
D) Lipid components of fungal membrane
Answer: C
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Chapter 4: Antigen Presenting Molecules
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Sample Questions
Q1) HLA class II molecule consists of:
A) Three glycosylated a-chains
B) Heavily glycosylated a- and b-chain
C) Two glycosylated a-chains and three b-chains
D) A single glycosylated a-chain bound to b2-microglobulin
Q2) CD1 molecules are similar in structure to:
I- HLA class I molecules
III- HLA class II molecules
III- HLA class III molecules
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q3) Human leukocyte antigen (HLA) class I molecules bind antigens:
A) At the ends and the antigens are larger than HLA class II antigens
B) At the ends and the antigens are smaller than HLA class II antigens
C) In the middle and the antigens are larger than HLA class II antigens
D) In the middle and the antigens are smaller than HLA class II antigens
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Page 6
Chapter 5: Antigen Presenting Cells
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Q1) Which type of dendritic cell activates both NK cells and CD8 T cells (CTLs) in response to a viral infection?
A) Follicular dendritic cells
B) Interstitial dendritic cells
C) Plasmacytoid dendritic cells
D) Interdigitating dendritic cells
Q2) Which type of dendritic cell does not present antigen, but instead aids B cell maturation into plasma cells?
A) Langerhans cells
B) Follicular dendritic cells
C) Interstitial dendritic cells
D) Plasmacytoid dendritic cells
Q3) The largest reservoir of interstitial dendritic cells is located in the:
A) Eye
B) Skin
C) Brain
D) Tonsils
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Chapter 6: Surface Interactions Between T Cells and Antigen-Presenting
Cells
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Q1) CD4 molecules on T cells bind to:
A) CD40
B) B7 molecules
C) MHC class I molecules
D) MHC class II molecules
Q2) How does alefacept function to reduce lesions in plaque psoriasis?
A) By blocking CD28/B7 interactions and causing T cell apoptosis
B) By blocking CTLA-4/B7 interactions and causing T cell apoptosis
C) By blocking CD2/CD58 interactions and preventing T cell activation
D) By binding to CD3 on activated T cells and preventing T cell activation
Q3) Why are the g/d T cells more similar to the innate immune response than the adaptive immune response?
A) They can present antigen to other T cells.
B) They are able to phagocytose pathogens.
C) They do not require activation to eliminate pathogens.
D) They recognize general features of pathogens rather than a specific epitope.
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Chapter 7: Intracellular Signaling and T Cell Activation
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Q1) The activation of the TCR through interaction with either MHC class I or class II molecules leads to signaling pathways that activate protein synthesis of:
A) IL-1
B) IL-2
C) TNF
D) ZAP-70
Q2) The major defect in X-linked severe combined immunodeficiency (SCID) is:
A) Inability to produce IL-2
B) Lack of ZAP-70 protein kinase
C) Inability to produce B or T cells
D) Lack of g-chain in interleukin receptors
Q3) The downstream signaling target of CD28/B7 activation is:
A) NF-kB
B) PIP2/IP3
C) Rac/JNK
D) PLCg1/DAG/PKC
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Chapter 8: B Cell Activation and Signaling
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Sample Questions
Q1) Which of the following is an example of a type I thymus-independent antigen?
A) Bacterial enzyme
B) Viral protein coat
C) Lipopolysaccharide (LPS)
D) Pneumococcal capsular polysaccharide
Q2) Most long-lived plasma cells reside in the:
A) Spleen
B) Thymus
C) Lymph node
D) Bone marrow
Q3) Which of the following are components of the BCR co-receptor complex?
I. CR2
II. CD19
III. CD22
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
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Page 10
Chapter 9: Antibodies
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Sample Questions
Q1) Fab fragments can be used clinically to treat:
A) Job syndrome
B) Digoxin overdose
C) Multiple myeloma
D) Common variable immunodeficiency (CVID)
Q2) Which region of the antibody is important for physical flexibility of the antigen binding region?
A) J chain
B) Hinge region
C) Secretory piece
D) Variable regions
Q3) The monomeric form of this antibody inserted into the B cell membrane serves as the B cell receptor (BCR):
A) IgA
B) IgE
C) IgG
D) IgM
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11
Chapter 10: Antibody Diversity
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Sample Questions
Q1) During recombination, which enzymes are responsible for formation of the DNA hairpins?
A) Endonucleases
B) RAG1 and RAG2
C) Artemis and DNA-dependent kinase (DNA-PK)
D) Multiple terminal deoxynucleotidyl transferases
Q2) Which of the following represents possible antibody conformations?
I. One l light chain, one k light chain, two g heavy chains
II. Two l light chains, one g heavy chain, one m heavy chain
III. Two k light chains, two m heavy chains
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q3) Somatic mutation theory of antibody diversity states that:
A) A limited number of genes undergo mutations
B) Separate genes exist for each antibody molecule
C) A limited number of genes undergo genetic rearrangements
D) The many genes inherited from both parents undergo a few mutations
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Chapter 11: Complement
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Q1) Which component is common to all three complement pathways?
A) C1
B) C2
C) C3
D) C4
Q2) Which of the following complement components acts as a chemoattractant?
A) C2a
B) C3a
C) C4b
D) C5b
Q3) What is the role of C9 in the complement pathways?
A) Creates pore
B) C3 convertase
C) C5 convertase
D) Binds to antibodies on microbe surface
Q4) The role that C3d plays in the immune response to pathogens is:
A) Activation of B cells
B) Activation of CD4 and CD8 T cells
C) Activation of the alternative pathway
D) Activation of inhibitory factors of the complement pathways
Page 13
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Chapter 12: Phagocytosis and Intracellular Killing
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Sample Questions
Q1) Following phagocytic ingestion of a pathogen, which of the following occurs?
A) Pinocytosis
B) Phagosome fusion with granules
C) Binding to antibody by Fc receptor on phagocyte
D) Binding to complement fragments by complement receptors
Q2) Why is enzyme replacement therapy with imiglucerase an effective treatment for some forms of Gaucher's disease?
A) Imiglucerase breaks down glucocerebroside.
B) Imiglucerase regenerates deficient myeloperoxidase.
C) Imiglucerase facilitates the production of active cytochromes.
D) Imiglucerase breaks down fungi when the body is not able to.
Q3) Some bacteria can avoid oxygen-dependent phagocytic killing by producing:
A) Catalase
B) Defensins
C) Singlet oxygen
D) Superoxide dismutase
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Chapter 13: Antibodies and in Vivo Therapy
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Q1) Bispecific antibodies can react with:
A) Two different antigens
B) Two of the same antigen
C) Antigen and T cell or NK cell
D) Four different antigens on the same cell
Q2) Radiolabeled antibodies to CD20, including tositumomab labeled with iodine-131, are frequently used to treat which disorder?
A) Multiple myeloma
B) Rheumatoid arthritis
C) Non-Hodgkin's lymphoma
D) Human immunodeficiency virus (HIV)
Q3) Hybridomas are fusion cells composed of:
A) B cells and T cells
B) Two different myeloma cells
C) Splenic B cells and myeloma cells
D) Lymph node B cells and splenic B cells
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Chapter 14: Antibodies and in Vitro Research and Diagnostic Assays
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Sample Questions
Q1) In flow cytometry, the side scatter and forward scatter are displayed on a graph with the purpose of:
A) Identifying specific surface markers
B) Separating populations of peripheral blood cells
C) Determining if a specific protein is present inside a cell
D) Determining if a specific signaling pathway has been activated
Q2) When treating leukemias and lymphomas, flow cytometry can aid the physician in diagnosis and treatment by:
A) Identifying increases in cell growth rates
B) Identifying changes in signaling pathways
C) Identifying if a drug has entered a cancer cell
D) Identifying surface markers on cancerous cells
Q3) When testing for HIV, patients can give a false positive ELISA result if the patient has which disorder?
A) Rheumatoid arthritis
B) Mantle cell lymphoma
C) Systemic lupus erythematosus
D) B cell chronic lymphocytic leukemia
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Chapter 15: Immediate Allergic Reactions
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Sample Questions
Q1) The late phase of asthma mainly involves:
A) Vasodilation
B) Inflammation
C) Anticoagulation
D) Bronchoconstriction
Q2) During an allergic reaction, IgE binds to Fc receptors on what cell types?
A) Mast cells and basophils
B) Monocytes and macrophages
C) Macrophages and neutrophils
D) Cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells
Q3) What is the difference between anaphylactic and anaphylactoid reactions?
A) Anaphylaxis causes more serious symptoms.
B) Anaphylactoid reactions do not involve mast cells or basophils.
C) Anaphylactoid reactions cannot be prevented and anaphylactic reactions are preventable.
D) Anaphylaxis is caused by IgE and anaphylactoid reactions are caused by complement.
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Chapter 16: Autoimmunity
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Sample Questions
Q1) In Goodpasture syndrome, antigens that are normally sequestered are exposed, and antibodies are produced that react with those antigens. What is a potential factor that could lead to exposure of these normally hidden self-antigens?
I. Toxins
II. Infection
III. Smoking
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q2) Patients with pernicious anemia have antibodies to:
A) Vitamin B
B) Hemoglobin
C) Intrinsic factor
D) Red blood cells (RBCs)
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Chapter 17: Transplantation
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Sample Questions
Q1) Without genetic modification, what is the main cause of rejection in xenotransplants?
A) Transfer of infection
B) Organs are the wrong size
C) The minor HLA antigens do not match
D) Pre-existing antibodies to alpha-galactosyl
Q2) The main immune response in a case of chronic rejection of a transplanted organ is:
A) B cell activation
B) Both B and T cell activation
C) Allospecific T cell activation
D) Attack of organ by pre-existing antibodies
Q3) The main immune response in a case of acute rejection of a transplanted organ is:
A) B cell activation
B) Both B and T cell activation
C) Allospecific T cell activation
D) Attack of organ by pre-existing antibodies
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Chapter 18: Antigen Presentation for Cell-Mediated Response
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Q1) Which of the following is most likely to generate a CD8 T cell response?
A) Tapeworm infection
B) Influenza virus infection
C) Fungal infection causing athlete's foot
D) Group A Streptococcus infection (Strep throat)
Q2) MHC class I molecules present antigen to:
A) NK cells
B) CD8 T cells
C) CD4 Th1 cells
D) CD4 Th2 cells
Q3) Which of the following is an example of an immune response following cross-priming?
I. An NK cell killing a tumor cell.
II. A CD8 cell killing a tumor cell.
III. A macrophage ingesting a tumor cell.
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
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Chapter 19: Delayed Type Hypersensitivity Reactions
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Q1) The main organ target for Coccidioides immitis is:
A) Lung
B) Liver
C) Heart
D) Muscles
Q2) What is the difference between a reaction to poison ivy and other delayed-type hypersensitivity reactions?
A) The poison ivy reaction is solely a CD8 response.
B) The poison ivy reaction is solely mediated by IgG.
C) The poison ivy reaction is solely an NK cell response.
D) The poison ivy reaction is solely a macrophage response.
Q3) What is an advantage of in vitro testing over the PPD skin test for TB?
I. The test is more accurate
II. The test can be completed in 1 day
III. The test is not affected by prior TB vaccinations
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
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Chapter 20: Cytotoxic T Cells
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Q1) Which molecules are required to stabilize the interaction between CD8 T cells and antigen presenting cells (APCs) that leads to activation of the CTLs?
A) Fas and FasL
B) CD28 and B7-1
C) TNF and TNF receptor 1 (TNFRI)
D) CD2 and lymphocyte function-associated antigen-1 (LFA-1)
Q2) Patients have a high risk of losing all of their teeth due which disease?
A) Melanoma
B) Papillion-Lefèvre syndrome
C) Autoimmune lymphoproliferative syndrome type 2
D) Familial erythrophagocytic lymphohistiocytosis type 2
Q3) When a CTL with FasL interacts with a target cell possessing Fas, what happens to the target cell?
A) The target cell dies via apoptotic cell death.
B) Nothing; the target cell is healthy and remains intact.
C) The target cell goes into cell cycle arrest and repairs damage.
D) Nothing, but the interaction with the target cell causes death of the CTL.
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Page 22
Chapter 21: Natural Killer Cells
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Q1) Which of the following cell types may play a role in allergic reactions, particularly in relation to asthma?
A) NK CD56dim cells
B) NK CD56bright cells
C) NKT type I cells
D) NKT type II cells
Q2) NK cells have cell surface receptors that contain immunoreceptor tyrosine-based inhibitory motifs (ITIMs), which bind ligand and recruit which type of molecule to transmit the inhibitory signal?
A) cAMP
B) Kinase
C) ATPase
D) Phosphatase
Q3) Which cell type can kill target cells using the perforin and granzymes method?
A) NKT type I cells
B) NKT type II cells
C) NK CD56dim cells
D) NK CD56bright cells
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23
Chapter 22: Factors That Influence the Immune Response
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Q1) Antigen-induced cell death (AICD) is mediated by:
I- Fas:FasL interactions
II- Perforin and granzymes
III- TNF-mediated cell death
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q2) Defects in Fas:FasL engagement and signaling may contribute to which disease?
A) Graves' disease
B) Rheumatoid arthritis
C) Type II diabetes mellitus
D) Systemic lupus erythematosus (SLE)
Q3) Which of the following is the outcome of T cell interaction with immature dendritic cells that do not express costimulatory molecules?
A) Anergic T cell response
B) Only CD8 T cells respond
C) Only CD4 T cells respond
D) Uncontrolled T cell response
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Chapter 23: Cytokines and Biological Modifiers
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Q1) A defect in production of cryopyrin leads to:
A) Increased synthesis of IL-2
B) Increased synthesis of TNF
C) Increased synthesis of IL-1b
D) Increased synthesis of IL-1a
Q2) Which of the following may be administered to treat rheumatoid arthritis?
I. Infliximab
II. Adalimumab
III. Canakinumab
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q3) Oprelvekin increases levels of:
A) Platelets
B) Neutrophils
C) Macrophages
D) Red blood cells
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Page 25
Chapter 24: Vaccines in Theory and Practice
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Q1) Which of the following is an advantage of live, attenuated vaccination over other types of vaccination?
A) Inexpensive to make
B) One dose produces immunity
C) Always stimulate mucosal and systemic immunity
D) Pose no health risks to immunosuppressed individuals
Q2) Which of the following is true concerning excipients in vaccines?
I. Excipients can cause allergic reactions.
II. Excipients may be purposefully added to vaccines.
III. Excipients may be contaminants from the manufacturing process.
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q3) What is the purpose of adding an adjuvant to a vaccine?
A) To reduce side effects
B) To enhance the immune response
C) To lower risk of allergic reactions
D) To prevent microbial contamination
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Chapter 25: Vaccine-Preventable Diseases
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Q1) Which type of tetanus involves Clostridium tetani organisms present in the middle ear and can cause facial paralysis?
A) Cephalic tetanus
B) Neonatal tetanus
C) Localized tetanus
D) Generalized tetanus
Q2) The diphtheria toxin targets cellular machinery, leading to the outcome of:
A) Increased transcription
B) Decreased protein synthesis
C) Increased DNA methylation
D) Decreased cAMP production
Q3) Children who take aspirin while they have chickenpox are at risk for Reye syndrome, which may be fatal due to organ damage. What is the cellular process that is affected by aspirin to cause organ damage?
A) DNA synthesis is inhibited.
B) ATP production is inhibited.
C) Protein synthesis is inhibited.
D) Detoxification of reactive oxygen species (ROS) is inhibited.
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Chapter 26: Acquired Immune Deficiency Syndrome
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Q1) Proteins from _______________ genes combine with RNase to form the viral reverse transcriptase complex?
A) Tat and rev
B) Pol and vpr
C) Vpu and nef
D) Gag and env
Q2) What protein protects viral RNA from degradation by host cell cytoplasmic enzymes?
A) gp120
B) RNase
C) Vif protein
D) Rev protein
Q3) Which class of drug results in the formation of disorganized viral capsids that form noninfectious viral progeny?
A) Fusion inhibitors
B) Protease inhibitors
C) Integrase inhibitors
D) Reverse transcriptase inhibitors
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