Immunology for Pharmacy
Midterm Exam
Course Introduction
This course offers a comprehensive overview of immunology, with a special focus on concepts relevant to pharmacy practice. Students will explore the structure and function of the immune system, including innate and adaptive immunity, antigen processing, and immunological memory. Emphasis is placed on the immune response to pathogens, mechanisms underlying immunological disorders such as hypersensitivities and autoimmune diseases, and the principles of immunization. The course also covers immunological aspects of drug action, vaccine development, and biologic therapies, equipping students with the foundational knowledge needed to understand and apply immunological concepts in pharmacy settings.
Recommended Textbook
Immunology for Pharmacy 1st Edition by Dennis Flaherty PhD
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26 Chapters
300 Verified Questions
300 Flashcards
Source URL: https://quizplus.com/study-set/1356 Page 2
Chapter 1: Cells and Organs of the Immune System
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Sample Questions
Q1) In positive selection, thymocytes undergo apoptosis when:
I-They do not interact with MHC molecules
II-They bind to MHC molecules with high affinity
III-They bind to MHC molecules with low affinity
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Answer: C
Q2) Aged red blood cells are destroyed by macrophages in the:
A) Tonsils
B) Lymph nodes
C) Peyer's patches
D) Splenic red pulp
Answer: D
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Chapter 2: Innate Immunity
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Sample Questions
Q1) The main immune component mediating septic shock is:
A) TNF-a
B) Defensins
C) Complement
D) Interleukin-10 (IL-10)
Answer: A
Q2) Nitric oxide (NO) produced by phagocytes is cytotoxic to pathogens by inhibiting pathogen:
I- DNA synthesis
II- Mitochondrial respiration
III- Cell wall synthesis
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Answer: C
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Page 4
Chapter 3: Immunogenicity and Antigenicity
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Sample Questions
Q1) Genetic factors that influence immunogenicity include:
I- Decreased functional capacity of the immune system over time
II- Lack of a T cell clone with a TCR that reacts to the antigen
III- Defect in antigen processing and antigen presentation
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Answer: D
Q2) 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
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Chapter 4: Antigen Presenting Molecules
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Sample Questions
Q1) Which of the following molecules are capable of presenting antigen?
I. CD1 molecules
II. HLA class I molecules
III. HLA class II molecules
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q2) Individuals who express HLA-DR13:
A) Can more easily clear hepatitis B virus
B) Are more susceptible to tuberculosis infection
C) Are more susceptible to Candida albicans infections
D) Can more easily eliminate respiratory syncytial virus (RSV)
Q3) Why are HLA heterozygotes more resistant to disease than homozygotes?
A) They have more single nucleotide polymorphisms.
B) They have a more diverse range of minor HLA loci.
C) They have more diversity in the antibodies they produce.
D) They have a more varied repertoire of antigen-presenting HLA molecules.
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Page 6
Chapter 5: Antigen Presenting Cells
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Sample Questions
Q1) Kupffer cells are a type of macrophage located in the:
A) Liver
B) Bone
C) Brain
D) Connective tissue
Q2) The largest reservoir of interstitial dendritic cells is located in the:
A) Eye
B) Skin
C) Brain
D) Tonsils
Q3) The purpose of the invariant chain is to:
A) Aid in receptor-mediated endocytosis in B cells
B) Guide MHC class II molecules to the endosome
C) Release antigen to stimulate memory cell formation
D) Aid in movement of the early endosome to a late endosome
Q4) After a Langerhans cell captures antigen, it travels to the:
A) Spleen
B) Lymph node
C) Bone marrow
D) Surface of the skin
Page 7
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Chapter 6: Surface Interactions Between T Cells and
Antigen-Presenting Cells
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Sample Questions
Q1) How are superantigens able to uniquely activate large amounts of T cells?
A) Superantigens secrete many toxins that are able to activate many different T cells.
B) Superantigens are able to travel to the lymph node to interact directly with more T cells.
C) Superantigens bind to the TCR and MHC class II molecule outside the binding groove.
D) Superantigens bind to the TCR in the binding groove like other antigens but they have more epitopes than other antigens.
Q2) According to the clonal selection theory, the activated T cell clone produces:
A) Only memory cells
B) Daughter cells that all have the same TCR
C) Daughter cells with different TCRs on the same cell
D) Multiple types of clones that each have different TCRs
Q3) T cells with the g/d TCR are primarily located in the:
A) Bone marrow
B) Lymph nodes
C) Mucosal tissue
D) Peripheral blood
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Page 8
Chapter 7: Intracellular Signaling and T Cell Activation
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Sample Questions
Q1) Which of the following is an example of autocrine signaling?
A) An NK cell responding to IL-12 produced by a macrophage.
B) A macrophage responding to TNF made by the same macrophage.
C) A T helper cell responding to IL-2 produced by a neighboring T cell.
D) A neutrophil responding to IL-1 produced by vascular endothelial cell.
Q2) What is one reason that basiliximab or daclizumab would be a better option for renal transplant patients than cyclosporine A?
A) Cyclosporine causes renal toxicity.
B) Cyclosporine stimulates the immune system.
C) Basiliximab and daclizumab increase renal function.
D) Basiliximab and daclizumab inhibit the whole immune system, not just T cells.
Q3) Cyclosporine A binding to cyclophilin blocks T cell activation by:
A) Inhibiting calcineurin and NFAT
B) Inhibiting RAP by binding to FKBP-12
C) Inhibiting IL-2 binding to the IL-2 receptor
D) Inhibiting calcineurin and protein kinase C (PKC)
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9
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) Which two cytokines are the main stimuli for B cell differentiation into plasma cells?
A) TNF and IL-1
B) TACI and BLyS
C) BLyS and APRIL
D) TLR-4 and Lipid A
Q3) Long-lived plasma cells are most likely to be produced in response to:
A) Thymic-dependent antigens
B) Type I thymic-independent antigens
C) Type II thymic-independent antigens
D) Both thymic-dependent and thymic-independent antigens result in production of long-lived plasma cells
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Chapter 9: Antibodies
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Sample Questions
Q1) 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
Q2) Which of the following antibody regions is involved in antigen binding?
I. Light chain variable region
II. Heavy chain variable region
III. Heavy chain constant region
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q3) Fab fragments can be used clinically to treat:
A) Job syndrome
B) Digoxin overdose
C) Multiple myeloma
D) Common variable immunodeficiency (CVID)
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Chapter 10: Antibody Diversity
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Sample Questions
Q1) The hypervariable complementarity-determining regions (CDRs) are primarily coded for by which gene region or regions?
I- Joining (J)
II- Variable (V)
III- Diversity (D)
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q2) The addition of N-nucleotides has which effect on antibody structure?
A) Determines if the light chain is a l-chain or k-chain
B) Allows for removal of amino acids in the open hairpins
C) Adds the C4 region to the heavy chain of some antibodies
D) Changes the amino acid sequence in the hypervariable CDR3
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) 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
Q2) In the alternative pathway, C3b can bind to which of the following?
I. To C3bBb
II. To factor B
III. The microbe cell surface
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q3) Which of the following components can act as an opsonin?
A) C1q
B) C3b
C) C4a
D) C5b
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Page 13
Chapter 12: Phagocytosis and Intracellular Killing
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Sample Questions
Q1) Which is a key component in oxygen-independent phagocytic killing?
A) Lysozyme
B) Myeloperoxidase
C) Hypochlorous acid
D) Superoxide dismutase
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) 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
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Chapter 13: Antibodies and in Vivo Therapy
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Sample Questions
Q1) The main pathological target for autoantibodies found in patients with Kawasaki disease is:
A) Skin
B) Kidneys
C) Platelets
D) Vascular endothelial cells
Q2) Low platelet count and antibodies to platelets are signs of:
A) Serum sickness
B) Kawasaki disease
C) Erythroblastosis fetalis
D) Idiopathic thrombocytopenic purpura (ITP)
Q3) Anti-Rh antibodies are used to treat:
A) Serum sickness
B) Kawasaki disease
C) Erythroblastosis fetalis
D) Idiopathic thrombocytopenic purpura (ITP)
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Chapter 14: Antibodies and in Vitro Research and Diagnostic Assays
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Sample Questions
Q1) 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
Q2) To identify different surface markers on a population of cells, flow cytometry requires the use of:
A) Enzymes
B) Colorimetric dyes
C) Radioactive isotopes
D) Fluorescent antibodies
Q3) In flow cytometry, side scatter is a measure of:
A) Cell size
B) Protein content
C) Granularity of a cell
D) Expression of CD markers
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Page 16
Chapter 15: Immediate Allergic Reactions
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Sample Questions
Q1) Which of the following is a true allergic reaction?
I. Latex allergy
II. Cockroach allergy
III. Radiocontrast media allergy
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q2) What role does histamine play in allergic reactions?
A) Increases vascular permeability
B) Stimulates eosinophil production
C) Stimulates granule release from mast cells
D) Prevents activation of the coagulation cascade
Q3) The late phase of asthma mainly involves:
A) Vasodilation
B) Inflammation
C) Anticoagulation
D) Bronchoconstriction
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Page 17
Chapter 16: Autoimmunity
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Sample Questions
Q1) Patients with pernicious anemia have antibodies to:
A) Vitamin B
B) Hemoglobin
C) Intrinsic factor
D) Red blood cells (RBCs)
Q2) The autoimmune response in patients with Goodpasture syndrome results in damage to the basement membrane of the:
A) Lungs and kidneys
B) Liver and pancreas
C) Heart and skeletal muscles
D) Thyroid and hypothalamus
Q3) The symptoms of myasthenia gravis are caused by:
A) Destruction of type IV collagen
B) Decreased levels of thyroid hormones
C) Destruction of acetylcholine receptors
D) Deposition of immune complexes in tissue
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18
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) How is the T cell response during transplant rejection different from the response during an infection?
A) Few T cells are responding during rejection
B) No T cells respond during rejection, only B cells
C) The number of T cells responding is much higher during rejection
D) The same amount of cells respond, but the response is stronger during rejection
Q3) One of the steps taken to avoid graft-versus-host disease (GVHD) is:
A) Immunostimulation
B) Matching minor histocompatibility
C) Removing all T cells from the graft
D) Removing all B cells from the graft
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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) 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
Q3) What is the purpose of b -microglobulin associated with MHC class I molecules?
A) Stabilization
B) Interacts with T cell
C) Anchors to membrane
D) Scaffolding molecule between TAP and MHC class I molecule
Page 20
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Chapter 19: Delayed Type Hypersensitivity Reactions
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Sample Questions
Q1) Which of the following is present in bat droppings, putting cavers at risk for this disease?
A) Coccidioides immitis
B) Histoplasma capsulatum
C) Mycobacterium tuberculosis
D) Mycobacterium avium complex (MAC)
Q2) Patients with celiac sprue need to avoid what agent?
A) Latex
B) Nickel
C) Gluten
D) Sumac
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) 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.
Q3) Tumor infiltrating lymphocytes (TILs) found in a solid tumor or melanoma may indicate:
A) A good prognosis due to small tumor size
B) A bad prognosis due to an aggressive cancer
C) A good prognosis due to a vigorous immune response
D) A bad prognosis due to damage to surrounding tissue by the immune system
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Chapter 21: Natural Killer Cells
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Sample Questions
Q1) A host cell that has been infected with the influenza virus and has subsequently downregulated MHC class I molecules is most likely to be recognized by which cell type?
A) T cell
B) B cell
C) NK cell
D) Neutrophil
Q2) Which is the main surface molecule on NK cells that is involved in antibody-dependent cell-mediated cytotoxicity (ADCC)?
A) CD3
B) CD16
C) CD56
D) CD94
Q3) Which of the following is true concerning natural killer (NK) cells?
A) NK cells never express CD16.
B) NK cells never express CD56.
C) NK cells express both B and T cell markers.
D) NK cells do not express B or T cell markers.
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Chapter 22: Factors That Influence the Immune Response
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Q1) 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
Q2) What is the outcome of matrilysin cleaving FasL from an activated T cell?
A) Soluble FasL is degraded and the activated T cell survives.
B) Soluble FasL binds to Fas and triggers the death of the activated T cell.
C) Soluble FasL binds to Fas and triggers the death of the regulatory T cell.
D) Soluble FasL is disseminated and causes widespread cell death in both immune cells and infected host cells.
Q3) Immune responses to idiotypes located outside the complementarity-determining regions (CDRs) result in:
A) Increases in autoantibody production
B) Downregulation of autoreactive B cells
C) Increases in activated regulatory T cells
D) Downregulation of MHC class II molecules on APCs
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Chapter 23: Cytokines and Biological Modifiers
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Q1) 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
Q2) Which of the following is an outcome of IL-1 release from activated immune cells?
A) Cleavage of viral RNA
B) Prevention of microbial growth
C) Increased production of antibodies
D) Downregulation of adhesion molecules
Q3) 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
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Chapter 24: Vaccines in Theory and Practice
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Q1) What is the difference between Freund's Incomplete Adjuvant (FIA) and Freund's Complete Adjuvant (FCA)?
A) FIA does not contain water.
B) FIA does not contain mineral oil.
C) FIA does not contain killed mycobacteria.
D) FIA does not contain mannide monooleate.
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) Which of the following is a conjugate vaccine?
A) Sabin polio
B) Hepatitis A
C) Rotavirus vaccine
D) Pneumococcal vaccine
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Chapter 25: Vaccine-Preventable Diseases
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Q1) Following resolution of the lesions of shingles, patients may continue to experience what symptom for months?
A) Pain
B) Arthritis
C) Immunosuppression
D) Swollen lymph nodes
Q2) A vaccine for diphtheria may be combined with vaccines for which of the following agents?
I. Pertussis
II. Hepatitis B
III. Haemophilus
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
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Chapter 26: Acquired Immune Deficiency Syndrome
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Q1) What protein protects viral RNA from degradation by host cell cytoplasmic enzymes?
A) gp120
B) RNase
C) Vif protein
D) Rev protein
Q2) 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
Q3) Which of the following drugs binds directly to HIV reverse transcriptase to inhibit activity?
A) Nevirapine
B) Zalcitabine
C) Raltegravir
D) Didanosine
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