Pharmaceutical Immunology Review
Questions
Course Introduction
Pharmaceutical Immunology explores the fundamental principles of the immune system and their application in the development, action, and evaluation of pharmaceutical products. The course covers key topics including the cellular and molecular mechanisms of immune responses, hypersensitivity reactions, immunodeficiency, autoimmunity, and transplantation immunology. Emphasis is placed on the role of immunological techniques in drug discovery, vaccine development, immunotherapeutics, and the assessment of drug safety and efficacy. Students gain an understanding of how immunological principles are integrated into pharmaceutical sciences for the prevention, diagnosis, and management of diseases.
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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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) The main function of _______________ is to ingest and destroy bacteria.
A) B cells
B) Eosinophils
C) Natural killer (NK) cells
D) Polymorphonuclear leukocytes (PMNs)
Answer: D
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Page 3
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) Which are the molecules that are common to many pathogens and are recognized by phagocytes and other innate immune cells?
A) PAMPs
B) Complement
C) Toll-like receptors
D) Mannose-binding lectin
Answer: A
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Page 4
Chapter 3: Immunogenicity and Antigenicity
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Q1) RhoGAM administered to an Rh-negative mother would help the patient by:
I- Preventing production of anti-Rh antibodies
II- Preventing fetal hemolysis in future pregnancies
III- Preventing transfusion reactions due to ABO mismatch
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Answer: C
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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Q1) 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)
Q2) In bare lymphocyte syndrome, individuals lack which surface molecules on their lymphocytes?
A) CD4
B) CD8
C) HLA class I molecules
D) HLA class II molecules
Q3) 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
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Chapter 5: Antigen Presenting Cells
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Q1) 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
Q2) The largest reservoir of interstitial dendritic cells is located in the:
A) Eye
B) Skin
C) Brain
D) Tonsils
Q3) Kupffer cells are a type of macrophage located in the:
A) Liver
B) Bone
C) Brain
D) Connective tissue
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Chapter 6: Surface Interactions Between T Cells and Antigen-Presenting
Cells
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Q1) 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.
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) The interaction between CTLA-4 and B7 leads to:
A) Downregulation of T cell signaling
B) Stabilization of the TCR/APC interaction
C) B cell activation and generation of memory cells
D) Production of proteins that regulate the cellular response to interleukin-2 (IL-2)
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Chapter 7: Intracellular Signaling and T Cell Activation
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Q1) Which of the following is/are part of the high affinity IL-2 receptor?
I. a-Chains
II. b-Chains
III. g-Chains
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 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.
Q3) 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.
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Chapter 8: B Cell Activation and Signaling
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Sample Questions
Q1) Most long-lived plasma cells reside in the:
A) Spleen
B) Thymus
C) Lymph node
D) Bone marrow
Q2) The phosphorylated immuno-receptor tyrosine-based activation motifs (ITAMs) of the BCR serve as a docking site for what adaptor protein?
A) Syk
B) NFAT
C) ZAP-70
D) Src kinase
Q3) X-linked agammaglobulinemia results from a defect in:
A) IL-7 gene
B) BTK gene
C) BLyS gene
D) CD22 gene
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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) An IgG2 subclass response is important for proper immunization with the meningococcal vaccine because:
A) IgG2 responds better to protein antigens
B) IgG2 responds better to carbohydrate antigens
C) Other IgG subclasses do not activate complement as efficiently
D) Other IgG subclasses are not always induced following vaccination
Q3) Antibodies with high affinity will be able to:
A) Tightly bind lower concentrations of antigen and quickly eliminate infection
B) Tightly bind higher concentrations of antigen and quickly eliminate infection
C) Loosely bind to lower concentrations of antigen and slowly eliminate infection
D) Loosely bind to higher concentrations of antigen and slowly eliminate infection
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Chapter 10: Antibody Diversity
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Q1) 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
Q2) 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
Q3) What is the purpose of the recognition signal sequences (RSSs) in rearrangement of genes?
A) The RSSs are the coding regions of the DNA.
B) The RSSs are the enzymes that facilitate recombination.
C) The RSSs are spacers that align genes on the same side of DNA.
D) The RSSs are the areas that determine the antigen-binding pocket.
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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) Which of the following components can act as an opsonin?
A) C1q
B) C3b
C) C4a
D) C5b
Q3) 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
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Page 13
Chapter 12: Phagocytosis and Intracellular Killing
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Q1) Patients with this disease are at greater risk for fungal infections than patients with other phagocytosis-related deficiencies:
A) Gaucher's disease
B) Myeloperoxidase deficiency
C) Chronic granulomatous disease
D) Complement receptor deficiency
Q2) Some bacteria can avoid oxygen-dependent phagocytic killing by producing:
A) Catalase
B) Defensins
C) Singlet oxygen
D) Superoxide dismutase
Q3) Which is a key component in oxygen-independent phagocytic killing?
A) Lysozyme
B) Myeloperoxidase
C) Hypochlorous acid
D) Superoxide dismutase
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Chapter 13: Antibodies and in Vivo Therapy
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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) 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) A monoclonal antibody used as a drug has a name that ends in what suffix?
A) U
B) Ab
C) Mab
D) Imm
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Chapter 14: Antibodies and in Vitro Research and Diagnostic Assays
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Sample Questions
Q1) Western blots are used to identify:
A) Different cell populations
B) Proteins in a complex mixture
C) Pregnancy hormone found in urine
D) Granularity and size of a population of cells
Q2) 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
Q3) 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
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Chapter 15: Immediate Allergic Reactions
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Sample Questions
Q1) 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
Q2) The late phase of asthma mainly involves:
A) Vasodilation
B) Inflammation
C) Anticoagulation
D) Bronchoconstriction
Q3) Hyposensitization therapy results in the production of:
A) IgA
B) IgE
C) IgG
D) IgM
Q4) Oral allergy syndrome is caused by:
A) Food allergies
B) Overproduction of eosinophils
C) Bacterial infection that stimulates IgE production
D) Cross reaction between shared antigens on food and pollen
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Chapter 16: Autoimmunity
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Sample Questions
Q1) The goiter associated with Graves' disease is caused by:
A) Inhibition of TSH receptors
B) Inhibition of TRH receptors
C) Constant stimulation of TSH receptors
D) Constant stimulation of TRH receptors
Q2) 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
Q3) Cytomegalovirus (CMV), as well as other infections, may contribute to the development of which autoimmune disorder?
A) Diabetes
B) Myasthenia gravis
C) Pernicious anemia
D) Systemic lupus erythematosus (SLE)
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Chapter 17: Transplantation
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Sample Questions
Q1) A patient may have pre-existing antibodies to a major or minor HLA antigen caused by:
I- Medication
II- Pregnancy
III- Previous transplant
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
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
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19
Chapter 18: Antigen Presentation for Cell-Mediated Response
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Sample Questions
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) As antigen is processed prior to loading onto MHC class I molecules, the antigens are degraded into smaller fragments by the:
A) Proteasome
B) Golgi apparatus
C) Phagolysosome
D) Endoplasmic reticulum (ER)
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
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20
Chapter 19: Delayed Type Hypersensitivity Reactions
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Sample Questions
Q1) Patients with celiac sprue need to avoid what agent?
A) Latex
B) Nickel
C) Gluten
D) Sumac
Q2) Which of the following can be found inside a granuloma?
A) Basophils
B) Eosinophils
C) Neutrophils
D) Macrophages
Q3) Defects in NRAMPs cause:
A) Phagosome dysfunction
B) Disruption of protein synthesis
C) Inability to package and release antibodies
D) Defective interactions between CD4 T cells and antigen-presenting cells (APCs)
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21
Chapter 20: Cytotoxic T Cells
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Q1) Which of the following is a method that tumors use to evade the immune response?
A) Producing IL-2 analogs
B) Reducing TAP function
C) Upregulating MHC class I molecules
D) Engaging Fas receptors on T cells to cause T cell death
Q2) 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)
Q3) 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
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Chapter 21: Natural Killer Cells
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Sample Questions
Q1) 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
Q2) If a host cell expresses both MHC class I molecules and ligands that bind activating receptors on NK cells, what is the outcome for the host cell?
A) The host cell will not be killed because the NK cell needs two different activating signals to kill a host cell.
B) The host cell will not be killed because the MHC class I molecules cause inhibition that overrides the activating signals.
C) The host cell will be killed because the NK cell does not bind MHC class I molecules and the activating signal causes cell death.
D) The host cell will be killed because the activating signal overrides the inhibitory signal caused by the MHC class I molecule binding.
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Chapter 22: Factors That Influence the Immune Response
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Q1) 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.
Q2) What is the immune response to high doses of antigen?
A) T cells are inactivated.
B) B cells are inactivated.
C) NK cells are inactivated.
D) Macrophages are inactivated.
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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24
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) NY-ESO-1 would be a beneficial addition to a cancer vaccine because:
A) It stimulates macrophages
B) It stimulates the production NK cells
C) It stimulates both CD4 and CD8 T cells
D) It stimulates a strong antibody response
Q3) Which is one disadvantage to cell-based anticancer vaccines?
A) Vaccines often must be patient-specific.
B) Vaccines may react with other host cells.
C) Vaccines with live cells do not have long-lasting effects.
D) Vaccines are less effective because they use allogeneic cells.
Q4) Recombinant IL-2 administration is appropriate for the treatment of:
A) HIV
B) Cancer
C) Arthritis
D) Transplant patients
Page 25
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Chapter 24: Vaccines in Theory and Practice
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Q1) 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
Q2) Which of the following pose little or no risk to immunocompromised individuals?
I. Subunit vaccine
II. Inactivated vaccine
III. Live, attenuated vaccine
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
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26
Chapter 25: Vaccine-Preventable Diseases
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Q1) Corynebacterium diphtheriae colonizes:
A) Heart and liver
B) Muscle and liver
C) Tonsils and pharynx
D) Kidneys and adrenal glands
Q2) In a vaccine such as Menactra, what is the main purpose of linking the capsular polysaccharides of Neisseria meningitis to the diphtheria toxin?
A) To stimulate a T cell-dependent immune response
B) To eliminate infections that commonly occur together
C) To add another vaccine to reduce the number of injections a patient receives
D) To prevent destruction of the polysaccharide antigens before an immune response can be mounted
Q3) Which of the following is a virulence factor for Haemophilus influenzae type b?
A) Pertactin
B) Polyribosyl phosphate
C) Polysaccharide capsule
D) Lipooligosaccharide (LOS) endotoxin
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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) Which of the following agents is/are entry/fusion inhibitor(s) administered to treat HIV infection?
I. Maraviroc
II. Enfuvirtide
III. Zidovudine
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
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