Micro Exam #1 1999 - ,r-1 5-1 ”(fig 53:15 3,y f v...

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Unformatted text preview: _;_,,r _.,., -1: 5-1; ”(fig 53:15:. 3; ,y. f v MICROBIOLOGY AND IMMUNOLOGY ' EXAM! SEPTEMBER 3, 1999 W l. 'I'hemainfunctionsofthisfamflyofsmicnuaHy-relatedcymldnesmtomctleukocytesfinmflie bloodtosites ofinflammationandtoactivaretherecmitedcells. Certainvimses,suchasHIV-l,utilize thereceptorsfordiesecytokinestogainentryinmocellssnchasmacrophagesandlymphocytes. What is the family? - A. lnterfemns B. Tumor necrosis factors C. Chemokines D. Hemopoietins E. interleukins 2. Which one of the following autoimmune conditions is character'md by progressive muscle weakness due to antibody against an important receptor involved in transmission of normal neuronal impulses? This condition if properly diagnosed and treated can result in a normal productive. life as exemplified by the current mayor of Louisville. A. myuthenia gravis B. Grtvc‘s disease C. insulin dependent diabetes melliflrs (IDDM) D. HashimmO’s thyroiditis E. systemic lupus etymematosus (SLE). 3. ~ ‘ Which ofthe fouowinghmnaninnmmoglobulhisispresentinthehighestconcenunfioninserumand canbeuansponednuosstheplacenminaprcguantfemale? A. m2 B. w c. 1.61 D. 1.1-: E- 130 4. A patient, who is immunodeficient and is incapable of clearing infecn'ons, becomes infected with a pathogenic strain of boomed; To resolve this infection, she should most likely not be tested with: A. Penicillin B. Ampicillin C. Kmanrycin D. Tmclene E. Metronidlmle Dmhgmmfibodymspongmemgiaityofanfibodykprommbypmceflsuwhashe? snow? . Peripheral blood Lymphatic vessels (thoracic duct) Dmininglymphnode Tissuesiteofinfection Liver Activation of the classical complement pathway by IgM antibody occurs following what sequence of events? $119.0 9"? AclusnerofIgMantibodymoleculeshashomdtoanantigen. AsmgleIngoleafleamchesmmanfimremmmgimfilmfconfigmfionthat is characteristic of plasma IgM molecules. A doublet of IgM molecules attaches to a mannan polysaccharide. A single IgM molecule attaches to multiple sites on an antigen, forcing it into its ”staple configuration that is capable ofactivating Clq. IgM attaches to 4 out of 6 of the collagcnous arms of a Clq molecule that has previously become bound to an antigen surface. Which of the following inhibim bacterial gynse? QWWDDWP Men-onidazole Rifnmpin Ciprofioxacin Amphotericin B W Trimethoprim Clarithromycin Inaconmle Competed to immunoglobulins, the structure of the human T cell receptor (T CR) most closely resembles the structure of: B. D. E. themsellularpm'tionofmembrane-nnchored IgE dimericlgAinsemm monomerichGinsm theFebfi'ngmentoflgG thchfngmentofIgG AtypeOwomanmnniedmntypeAmnncnrfiesatypeAfems. Whydon‘ttheanti—AB isoantibodies offliewomanamckthetypeAerythrocymofthefems? A. B C. D ApregmmwOwunmwiflnmmakemfibodiesmcdvewithmyfeulnmocyte mtigens. '- TheABOismnn'bodiescumotscfivnecomplememmdmerefondonotcanselysis ofthefetnlerythrocytee FMayflnocfiesdondacpresfidispkymeeUaflncehnybloodgmupmfigens. The carbohydrate antigens constimtingtbe ABO system induce Teen-independent respmseslknceJheABOBonnnhodiesuepredommnmlylnghichdonotcm“ theplncum. ) 10. CytotoxicTcellsflc)killvirusinfectedcellsby:. A. Releasing peroxides and nitric oxide. B Releasing ehemokines. C Releasing interferons. D Releasing perform and granzymes E Polymerizing C9. 11. ApenicMwhichisresisnntmflieadivityofbeta-lactamaseis: A. Amoxicillin B. Monobactam C. Ampicillin D. Mezlocillin E. Methicillin 12. Cyclosporin, a powerful immunosuppressive drugthanacts by inhibiting the production of interleukin-2 (IL-2), is routinely used to prevent rejection of transplants. Based on this property, which of the following immunological processes is directly afiecmd by this drug? ?’ Lymphocyte proliferation B Recnritmentofmacrophagesintothegramdorgan C. Production of leukocytes by the bone marrow (hemopoiesis) D. Activation of endothelial cells E Recognition of antigen 13. The immunologically important enzymes known as RAG-1 and RAG-2 directly participate in which of the following processes ? A. rearrangement of immunoglolmlin V, D and J DNA segments B. somatic hypermutation of irnmunoglobulin genes C. class-switching of immunoglobulin gene products D. splicing of mRNA to produce IgD E. somatic hypermutation of T-cell receptor genes 14. Resistancetoteu'acyclineismost oftenby: A. Aneflluxrnechanism B. ByalmingtheSOSribosome C. ByalteringRNApolymer-ase D. Byenzymaticdegndation E. Byalmingthecellwall 15. ThefissmdmngefimacwshTyPthypasensifivhymcfiomiscausedmedommamlyby A when E nann'al killer cells. C. neutrophils. D. eosinophils. E Tc cells. l6. l7. 18. 19. 20. Whicheneofthefoflowhgdoanotapplywsystunichipusayfliematosus(SLE)? A. B. C. D. E. itismorecommoninfemales. , ‘ , L chmcterizedbytissuedepositionofimmunecomplexes. . theresponsefi'equenflyinchidescytotoxic'l‘lymphocyws. symptomsincludeglomerulonephritisardiritismsh. hresultsfiomimmmeeomplmtesofDNAsnRNPsetc. Which of the following cell types isthe most importantacoessory cell for positive selection of “double- positive” (CD4‘CD8‘ ) thymocytes during maturation of T cell precursors, and is distinct from - “professional” Antigen presenting cells because this cell type is not bone marrow-derived? ' WPDW? cortical epithelial cell follicular dendritic cell cortico—medullary dendritie cell stromal cell secreting lL-7 medullary macrophage Which one of the following is an efi‘ective, but not very toxic antifimgal antibiotic? A. B. C. D. E. ‘Which of the following proteins is NOT involved in the processing and presentation of “endogenous” , #3 Metronidazole Ciprofloxacin Nymfin Ketoconazole Cefazolin protein antigens to human T lymphocytes ? meow? HLA—A TAP-l HLA-C HLA-DM LMPoZ Interferon-a (ll-'Na.) is a cytokine that is sometimes prescribed for patients suffering from chronic viral hepatitisB orC. Whatisthebasis forthistherapy’? WPOF’? IFNa stimulates antibody production by B lymphocytes , lI-‘Na inhibits preventsdamngetoflielivercaused bythe virus lI-‘Na. stimulates production of acute phase proteins and complement by hepatocytes IFNa has direct anti-viral activities and activates NK cells that kill vims—infecwd cells l'FNa prevents the destruction of hepatocytes infected by the virus' 21. Nahualkiller(NK)cellswillkillat'Bsueeellifi- A. ‘ thensmcefldwphystoohuleclassIMHCmengageflieNKlnhibnmyRecepmr -mmm. B. thetissuecelldisplaysCMonitsmemhr-ane. C. thetissuecell displaysviralDNA encodingforCD40—like molecules.- D. fliefissuecefldisplaysviralpepfidespreeentedonclaaslhfliCmoleculea E. thetissuecell displaysmutamdorabnormal proteinsonitsm-brane.’ 22. Which of the following molecular mechanisms is responsible for both co-expression of IgD and IgM . bynaive Bvcells and co-expression ofmembrane-bwndand secreted 1g by activatedB cells ? A. gene duplication of rearranged Ig heavy chain coding sequences B co-expression of rearranged Ig heavy chain coding sequences from both copies of human chromosome 14 C. ribosomal frameshifting within coding sequences for heavy‘chain constant domains D. proteolytic cleavage of Ig heavy chain polyproteins and intermolecular disulfide bond formation between heterologous protein fi'agments E alternate polyadenylation site selection and corresponding alternate RNA splicing for RNA transcripts ofrearranged Ig heavy chain genes . Items 23-25. A. Diaminopimelic acid F. Safianin B. C55 isoprenoid alcohol G. L-form C. Autolytic enzyme I-I. Peptidoglycan D. Lipid A I. Capsule E. Pill * From the above choices, select the most appropriate response to the statements below. 23. Strumusedbybactefiatoattachtomucosalsurfaces 24. A major pathogenic factor; carbohydrate or amino acid polymer, outer covering of bacterial cells 25. Substance implicated to participate with penicillin in killing bacterial cells 26. Patients sufi'ering from severe allergies and asthma usually have elevated levels of IgE antibodies in theirsenrm. 'I'hisisthoughttobeduetoover-activation ofth cells and productionofacytokinethat induces B lymphocyms to switch antibody production to 135. In fact, inhibitors for this cytoldne might beusefillinthetherapyoftheoe allergiceonditions. Which cytokine isdirectlyresponsible forthis efi‘ect? WpOP? Warm-1 (FM) lnterleukin4 (IL-4) Tumor necrosis factor-a ('I'NFn) Interleukin-l Chemokines itemsZ'I-SZ: ' ‘ ’ A. Passive Immunity ' ‘ F. AntigenicCompefition B. Innatelmmnnity , :‘G. ClonalDeletion » - . ( C. Cell Mediated Immunity H. Anergy ' ‘ ‘ D. Split Tolerance I. Cytokine Antagonism E. Immune Deviation J. Doctrine ofOriginal Antigenic Sin Choosetlie most appropriateitem fromthe listabovetorespondtothe statements below. 27. he infusion of an antiserum orantibodies intoapatient provides transientprowction describedbythis _ 28. The loss of self-reactive immature B cells during development is a result of this process. 29. This term refers to the coxmter-halance between cell-mediated immunity and humoral immunity. 30. Thefiflmcofmmfigmpresenfingcenmpmfidetherequhedcmsfimulatorysignalsmmmfigm reactive Th cell can result in this phenomenon. ‘ 31. 'I'h2cellscaninterferewiththedevelopmentof’l‘hl cellsbythisprocess. 32. The acute inflammatory response, with its attendant increased vascular permeability, is a component of this system. 33. Which one of the following 15 a metabolism inhibitor and 1s usually a pm of the multidrug regimen against tuberculosis? A. Chloramphenicol B. Ampicillin C. Ciprofloxacin D. lsonian'd 5- Polymmn E F. Metronidamle 34. CD28 and CI'LA-4 are cell-sm'face proteins which are important in the initiation and regulation of T lymphocyte activation and proliferation. Which of the following statements concerning CD28 and C’I'LA-4 is incorrect ? A. CD28ispresentonbothCD4’TcellsandCD8‘Tcells the ligands for both CD28 and CTLA-4 are constitutively expressed on lymphoid dendritic cells we ligands for both CD28 and CTLA-4 are expressed on macrophages following macrophage activation me ligands for CD28 and CTLA-4 are non-HIA “B7 proteins” (B7.l and B72) CD28bindstoB7withmuchhigherafiinityfl1antheafiinityoi’CTLA-4 forB7,to send a negative signal via the cytoplasmic inhibitory domain of CD28 9!” WP 35. 36. 37. 38. 39. Intheclassicalpatlrwayofcomplememacfivalion, substratemodifieationisrequiredattwostagesfor promolytic cleavage of complement protein substrates. Which complement protein substrates require such modification for proteolytic cleavage? A. B C. D Clq ismodifiedbylngorcleavagehyClr, andC3 ismodifiedbyattachmentto C4, allowing cleavage by 02a. 04 ismodifiedbyattaehmenttoCBb, allowing cleavage by C2b, and C5 is modified by attachment to C3b, allowing cleavage by C15. C2 is modifiedby attachmenttoC4b, allowingcleavage byactivatedCl, andCS' 15 modified by attachment to C3b, allow'mg cleavage by C4b, C2b. The C1 trimolecular complex is modified by attachment to planar IgM toallow Cls cleavage of Clr, and C3 attachment to C5b allows cleavage by C4b,C2b (C3IC5 convemse). C4 binding to planar IgM permits Cls cleavage of C3, and C5 attachment to C3b allows C4a,C2a cleavage of C3b. Ofthe 4 types ofhypersensitivity, to which type is activation ofThl cells critical? $7.05”? Rearrangement of DNA sequences encoding the immunoglobulin (lg) and T cell receptor (T CR) variable regions occurs in an ordered fashion involving V-D-J or V-J DNA segments. Which one of the following DNA rearrangement events is incorrect for maturation of T and B cell precursors ? A. B. C. D. E. 1g 3: (kappa) rearranged before 1g 7. (lambda) TCR a rearranged before TCR B Ig heavy chain rearranged before 1g light chain V-D-J segments rearranged for Ig heavy, TCR fl and TCR 5 (delta) V-J segments rearranged for lg lighg TCR o. and TCR 7 (gamma) Which of the following cells CANNOT participate in Ann'body.Dependent Cell-mediated Cytotoxicity (ADCC)? B. C. D. E. Mactcphage Neutrophil ' Basophil Eosinophil NK cell Which of the “anaphylatoxin” peptides 15 released only by the classical pathway (or lectin pathway), but not by the activation of the alternative pathway of complement? , E” B C. D. E CSa I ll' . C21 C41! C3a Whiehofthe followingclasslarclassllmgmsonhnmanchromosonIeG exhibitstheleastgenetic ‘ ‘ polymorphism, with only a single invariant allele ? l A. HLA-A B. HLA-DRa C. HLA-C D. IRA-DEB E. HLA- DQB 41. Whichoneofthe followingisanexampleofatypeIVautoimmunedisease, diesymptomsofwhieh include regional ileitis and whichistreamblebysurgioalremoval ofseairedtissue orarecentlyFDA approved therapeutic protein? ' A. myasthenia gravis B Grave’s disease C. Crobn‘s disease D. HBhimoto’s thyroiditis E systemic lupus erythematosus (SLE) Items 42-47. A. Margination F LFA-l B. Diapedesis G. E-Selectin C. Chemotaxis H. lCAM-l D. Phagoeytosis 1. IL-8 E. Opsonintion J. IL-lO Choose the most appropriate Item from the list above to respond to the statements below. 42. 43. .45. 46. 47. This term refers to the sticking/adhesion of neutrophils to the lumen side of venules at sites of inflammation. This molecule is primarily responsible for neutmphils rolling to a stop in venules at sites of inflammation. n'l'hisisatermappliedaotbeefi'ectofcoatingabaotefialeellwithC3borantibodytofacilitate phagocytes-L Chemokines prom this activity in leukocytes that have exited from blood vessels into inflamed tissue. This molecule is a chemokine for hemophils. Thiscelladbeaioumoleuileisoneoftbe ligandstowhich integrinsbindinordertoformtightadhesions betweeneellanmtindfiurimmxme function. u 49. 51. 52. WhichoneofthefollowingsmentsdoesNOTdesciibethereaetionsinfeimemationofglucosein lacticacidbaen'eria? -- ‘ - ' ' A. OxidizednicofinamideadeninedinucleofideOiAD‘fisusedasacofiactor. B. They provide energy by substrate level phosphorylation. C. Theyoccurhifliecytoplasmofthebacterialcell. D. They utilize inorganic compounds as alternative electron acceptors. E. The net energy yield is 2 moles of ATP per mole of glucose. Considerbacterialchemotaxis. Whenabaetezialcellswimsthroughincieasingconcenn-ationsofan anraetantsuchasasugar,thechemotacticresponseis: increased tnrningofthe flagellmninacounterclockwise direction A. B. decreased runs of smooth swirnmmg C. inhibition of flagellar roation D. random tumbling E. methylation of Che proteins Recognition of “mfigmpresenting cells” (APCs) by T lymphocytes requires interaction of TCRs with ham self—HLA proteins and bound peptides in complexes on APCs. Which of the following hypervariable “complementarity-determhiing regions” of the TCR contributes most to the direct interaction with the bound foreign peptide? ‘ A. CDRl B. CDRZ C. CDRS D. both CDR2 and CDR3 contribute equally E. all three regions (CDRl, CDRZ and CDR3) contribute equally KDPG (2-keto-3-deoxy-6—phosphogluconate) aldolase is specific for which of the following metabolic pathways? A. Embden Meyerhofi Parnas (EMF) pathway B. Tricc'boxylic acid (T CA) cycle C. ‘ Oxidative pentose phosphate pathway D. Gl’yoxylate cycle E. . Emeeruodom‘fl’ (ED) pathway A‘nun'ifional down-shin from a rich medium to a minimal medium increases the duration of which phase ofbacterial powth? 1‘» mph-sf B. Exponamnlphase C. Stationuypbase -' D. Declinephase E. mmdcphase 53. a. 55. 56. InADCC reactionsNKcellscanbindto, and-kill,=eells mwiflrlgG antibody using a receptor specific for: $1155.05”? -- Peptidespresentedonhfl-IC classI. PeptidespresentedonMICclassIl Vimsproteins. . a Integrins. 7_ chomainsofIgG. - I Anofthefouowmgmmngardingfawhafivembicbactefiaueconectuoept m? C. D. E marker for: A.. B. C. D E. In patients with systemic lupin erythematosus (SLE), circulating immune complexes activate and W Theygrowinthepresenceorabsenceofoxygen. 'I'heylacksupermtidedisnunse. Theytransport carbohydratesprimarilybythephosphou'ansferasesystem. Theygrowinallregionsofmbesconrainingthioglycollatemedium. Thcymaycanyoutanaerobicrespirafion. ' The complex of proteins known as CD3 (CDB 1,5, 1-: and dimeric Q is a characteristic cell-surface alchells onlchellswithTCR a-Bchains onlchellswithTCR'y-S chains onlchellswithCD4 only'l‘cellswithCDS consume complement, resulting in hypocomplemcnwmia. With lower levels of circulating immtme complexes, a better indication of ongoing low levels of complement activation is the measurement of serum levels of complement protein split products. Of the complement fragments present in blood of SLE patients, levels of the Bb fiagment of fictor B have shown the best correlation with levels of immune complexes and disease. Since immune complexes activate the classical pathway, why do you thinkthatthere areelevated levels ofBbfragmentin serafrom patients with $1.13? A. B. Immune complexes containing DNA and anti-DNA primarily activate the alternative pathway and not the classical pathway. Activation of neutrophils by circulating immune complexes nigger: the release of proteolytic enzymes fiom cytoplasnic granules such as elastnse or cathepsin D that cleave factor B into Bb and Ba fragments. Inpatientswith SLE, consumption ofthecontrolproteins factorHand factorlresuhs in the disregulation of the alternative pathway and the spontaneous cleavage of factor B molecules by factor D. Deposition of C3b onto immrme complexes bythe classical pathway results in capture of factor B by the bound C3b molecules, triggering activation of the alternative pathway of complement and release of Bb fragments afier the normal spontaneous decay of the C3b,Bb complexes. Very high levels of circulating immune complexes with bound Cls are able to cleave factor B directly, resulting in low levels of Bb fragment in the circulation. lO .r-x 57. 58. 59. 61. AtypicflmhhnflmedimfmfiegowfiofachmothMSpomsshmphosphmbufia, nacememlgandwhichofthe following? A. ' fatty acids and yeast met B. glucose and ammonium ions C. peptone D. CO2 and sulfate ions E. glucose and beefexn-act Which of be following descriptive phrases is incorrect for the CD45 molecule? has protein tyrosine phosphatase'activity in cytoplasmic domain ' deliversinhibitorysignaltoTcellsafierligafionwithB7onAPC augments signalingbyTCRsonmatureTcells activatesnon—receptortyrosinekinaseslckandl-‘yn augmentssignalingbyBcellreceptorsonmatmeBcclls WPDW? All ofthe following statements about transport proteins in bacteria are true except: P porin activity is energy independent B maltose-binding protein is located in the periplasmic space , C. lactose permease is loaned in the cytoplasmic membrane of gram-negative bacteria D. Hprandenzymelarebothspecificforfliesugarlhatisu'amported E. FepA binds the Fe”-enterochelin complex The secondary ann’bodyresponsedifl‘ersfiomtheprimaryantibodyresponseinall ofthe following - waysEXCEPT: . A. Ann'bodyaccumulammsennnmorerapidlyinthe secondaryrccponsethaninthe primaryresponse. B Tbequanmyofannbodyproduwdishighermtbesecondarymponsethanmflie primaryresponse. C. The mondary response is T-independen: whereas the primary response isT- dependent. , D Theafinityofanubodyforthemfigenishighermmeseeondarymponsethaninthe E. Wmcdmdoesnotprecedelngroductioninthesccondaryrsponse. Whatisthenetmolaryieldofeuergy(ATPandGTP)whentwomolesofpymatearecompletely oxidized to C0, by a bacterial cell? In your calculations, make the following assumptions: no energy is required forpyruvatetnnsport; glycolysis,the TCA cycle, and oxidative phosphorylan'on arefully active;andtheP:Oraxio-3. FLUFF? '3’ ll 62.- Whichoneoffliefonowmgtypesofgafisanmsuhhhypmemerejecfimdnewpmfomed antibodies? Assumethatfliepafientmceivedanglflndoseofn‘iplehnmunosuppressives. ‘N A. discordant xenografi * B. syngrafi C. allografi D. autografl E. photografi 63. InNeisseriaandPseudamonasfiiepresenceofac-typccytochmmeintheelecu'onu-ansportchainis the basis of a positive: A. Vogec-Proskauer m B. Methyl red test C. Oxidase m D. Catalase ms: . E. Nitrate reduction test .. 64. Which of the following M do pg; represent a T cell molecule and its corresponding A. CD20nTcellzLFA-3onAPC B. CD4 onT-cell :HLA-DP onAPC C. CDSon‘l‘cellzl-ILA-BonAPC D CD28:B7onAPC E. CD45: ICAM-Z on APC 3 Items 65-66: A. Neutmphil F. Lymphokine Activated Killer (LAK) B. Eosinophil G. Th! lymphocyte C. Mast Cell H. 1112 lymphocyte D. Dendritic Cell I. lmnepiihelial Lymphocyte (IEL) . E Monocyte 1- B Lymvohcym Choosethemostappmprineitemfiomdielistebovemrecpondtothemtsbelow. 65‘. Whichoellisfliepmcurso...
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