Immunology — MCQs

Immunology Indian Medical PG Practice Questions and MCQs

Question 1001: Which human IgG subclass has the highest serum concentration?

A. IgG1 (Correct Answer)
B. IgG2
C. IgG3
D. IgG4

Explanation: ***IgG1*** - **IgG1** constitutes approximately **60-70%** of the total IgG in human serum, making it the most abundant subclass. - Its high concentration reflects its crucial role in **neutralizing toxins**, agglutinating viruses, and opsonizing bacteria for phagocytosis. *IgG2* - **IgG2** makes up about **20-30%** of total IgG and is primarily important in protecting against **polysaccharide-encapsulated bacteria**. - While significant, its serum concentration is notably lower than that of IgG1. *IgG3* - **IgG3** is the least abundant IgG subclass, accounting for only **5-8%** of total IgG, and is characterized by a shorter half-life. - Despite its low concentration, it is highly efficient in activating the **complement system** due to its flexible hinge region. *IgG4* - **IgG4** comprises approximately **3-6%** of total IgG and is unique for its ability to undergo **Fab arm exchange**, leading to bispecific antibodies. - It does not activate complement and is often associated with allergy and protection against parasitic infections, but its concentration is significantly less than IgG1.

Question 1002: Which of the following is a specific feature of acquired immunity?

A. Immunological memory (Correct Answer)
B. Affected by genetic makeup
C. No antigen exposure
D. Immediate response

Explanation: ***Immunological memory*** - A key characteristic of **acquired immunity** is the ability to "remember" previous encounters with specific pathogens. - This memory leads to a more rapid and robust immune response upon subsequent exposure to the same pathogen. - This is the **defining feature** that distinguishes acquired immunity from innate immunity. *Affected by genetic makeup* - While genetic makeup can influence the *efficiency* of the acquired immune system, it is not a **specific feature** that distinguishes it from innate immunity. - **Both innate and acquired immunity** are affected by genetic factors, determining baseline resistance and immune response capability. *No antigen exposure* - **Acquired immunity** is specifically characterized by its *dependence* on antigen exposure to develop specific responses. - The phrase "no antigen exposure" describes how the **innate immune system** functions, providing immediate, non-specific protection without prior contact with a pathogen. *Immediate response* - **Innate immunity** provides an immediate, non-specific response to pathogens. - **Acquired immunity** takes time to develop (days to weeks) after initial antigen exposure, but provides a faster response upon re-exposure due to immunological memory.

Question 1003: Which immunoglobulin does Protein A of Staphylococcus aureus bind to?

A. IgA
B. IgG (Correct Answer)
C. IgD
D. IgE

Explanation: ***IgG*** - **Protein A** of *Staphylococcus aureus* binds to the **Fc region** of IgG antibodies. - This binding mechanism helps *S. aureus* in **evading opsonization** and phagocytosis by interfering with the host immune response. *IgA* - IgA is primarily found in **mucosal secretions** and its primary role is in mucosal immunity. - Protein A does not preferentially bind to IgA; instead, some bacteria produce specific **IgA proteases** to cleave and inactivate IgA. *IgD* - IgD is found mostly on the surface of **B lymphocytes** and its main role is in B cell activation. - Protein A does not have a significant binding affinity for IgD. *IgE* - IgE is involved in **allergic reactions** and defense against parasites. - Protein A does not bind to IgE; binding to IgE is typically mediated by specific IgE receptors on mast cells and basophils.

Question 1004: IFN-gamma is produced by

A. Macrophages
B. T-cells (Correct Answer)
C. Neutrophils
D. B-cells

Explanation: ***T-cells*** - **Interferon-gamma (IFN-γ)** is a crucial cytokine primarily produced by **activated T-lymphocytes**, especially **Th1 cells** and **cytotoxic T lymphocytes (CTLs)**. - Natural killer (NK) cells also produce **IFN-γ**, which plays a key role in **antiviral** and **antitumor immunity**, as well as in promoting **Type 1 immune responses**. *Macrophages* - While macrophages are **responsive to IFN-γ** (e.g., becoming activated), they are not the primary producers of this cytokine. - Macrophages primarily produce other cytokines such as **IL-1, IL-6, TNF-alpha**, and **IL-12** in response to infection or inflammation. *Neutrophils* - **Neutrophils** are key phagocytes in the innate immune system and are primarily involved in engulfing and killing pathogens. - They are not known to be a significant source of **IFN-γ** production; their main defensive mechanisms involve **phagocytosis**, **degranulation**, and **NETosis**. *B-cells* - **B-cells** are central to humoral immunity, specializing in **antibody production** and acting as **antigen-presenting cells**. - They generally do not produce **IFN-γ**; instead, their cytokine repertoire includes **IL-10**, **IL-6**, and **lymphotoxin**.

Question 1005: The process by which antigen-specific B lymphocytes are selected and activated to proliferate and produce antibodies is called:

A. Clonal selection (Correct Answer)
B. Class switching
C. Group switching
D. Hybridisation

Explanation: ***Clonal selection*** - **Clonal selection** is the fundamental process by which an antigen-specific B lymphocyte is **selected** when its B cell receptor (BCR) recognizes and binds to a matching antigen. - This binding triggers the B cell to become **activated**, **proliferate** (undergo clonal expansion), and **differentiate** into plasma cells that produce antibodies specific to that antigen. - This process is the cornerstone of **adaptive immunity**, ensuring that only B cells with receptors matching the encountered antigen are stimulated to respond. *Class switching* - **Class switching** (isotype switching) occurs AFTER clonal selection and activation. - It allows already-activated B cells to change the **antibody class** they produce (from IgM to IgG, IgA, or IgE) while maintaining the **same antigen specificity**. - This process modifies effector functions but does NOT involve the initial selection and activation of antigen-specific B cells. *Group switching* - This is not a recognized term in immunology. - It does not describe any standard process of B cell activation or antibody production. *Hybridisation* - **Hybridization** refers to the formation of double-stranded nucleic acids from complementary strands or the creation of hybrid cells (e.g., hybridomas for monoclonal antibody production). - It is not the physiological process by which B lymphocytes are selected and activated in response to antigen exposure.

Question 1006: Interleukin 2 is produced by

A. T helper cells 1 (Correct Answer)
B. T helper cells 2
C. Natural killer cells
D. Basophils

Explanation: ***T helper cells 1*** - **T helper 1 (Th1) cells** are a primary source of **interleukin-2 (IL-2)**, which is crucial for the proliferation and survival of T cells. - IL-2 acts as a **T-cell growth factor**, promoting the expansion of activated T cells, including cytotoxic T lymphocytes. *T helper cells 2* - **T helper 2 (Th2) cells** primarily produce cytokines like **IL-4, IL-5, IL-6, IL-10, and IL-13**, which are involved in humoral immunity and allergic responses. - While Th2 cells are important for immune responses, they are not major producers of IL-2. *Natural killer cells* - **Natural killer (NK) cells** are part of the innate immune system and produce cytokines such as **interferon-gamma (IFN-$\gamma$)** and **tumor necrosis factor-alpha (TNF-$\alpha$)**. - They are not a significant source of IL-2, which is primarily a T-cell derived growth factor. *Basophils* - **Basophils** are granulocytes involved in allergic reactions and anti-parasitic immunity, producing mediators like **histamine** and cytokines such as **IL-4** and **IL-13**. - Basophils do not produce IL-2; their role is distinct in the immune response compared to T cells.

Question 1007: In the context of immune response, which of the following cell types does not express MHC class II molecules?

A. Cortical macrophages
B. Neutrophils
C. Medullary macrophages
D. NK cells (Correct Answer)

Explanation: ***NK cells*** - **Natural Killer (NK) cells)** are innate lymphocytes that do **NOT express MHC class II molecules** under any circumstances. - NK cells use alternative recognition mechanisms (KIRs, activating receptors) to detect target cells, primarily recognizing the **absence of MHC class I** or stress-induced ligands. - They function in innate immunity without antigen presentation capability. - **This is the best answer** as NK cells never express MHC class II, making them distinctly different from professional APCs. *Cortical macrophages* - **Cortical macrophages** in lymphoid organs are professional **antigen-presenting cells (APCs)** that constitutively express **MHC class II molecules**. - They present processed antigens to CD4+ T helper cells, playing a crucial role in initiating adaptive immune responses. *Medullary macrophages* - **Medullary macrophages** are also professional APCs that constitutively express **MHC class II molecules**. - They participate in antigen presentation and immune surveillance within the medullary regions of lymphoid tissues. *Neutrophils* - Neutrophils are granulocytes that **typically do not constitutively express MHC class II molecules** in their resting state. - However, under certain inflammatory conditions with prolonged stimulation (IFN-γ, GM-CSF), neutrophils can be induced to express low levels of MHC class II. - While neutrophils generally lack MHC class II, **NK cells are the more definitive answer** as they never express MHC class II under any physiological or pathological conditions.

Question 1008: What is the primary use of the Hybridoma technique?

A. Monoclonal antibodies (Correct Answer)
B. Antigen
C. Specific antibodies
D. Cytokines

Explanation: ***Monoclonal antibodies*** - The **hybridoma technique** is primarily used to produce **monoclonal antibodies (MAbs)**, which are highly specific antibodies derived from a single B-cell clone. - These antibodies recognize a **single epitope** on an antigen, providing exceptional specificity and uniformity. - The technique involves **fusing a B-lymphocyte** (antibody-producing cell) with a **myeloma cell** (immortal cancer cell) to create a hybridoma that continuously produces identical antibodies. - This is the **gold standard** for producing large quantities of identical, highly specific antibodies for diagnostic and therapeutic use. *Specific antibodies* - While monoclonal antibodies are indeed specific, this term is **too vague** and could refer to any antibody with specificity, including polyclonal antibodies. - **Polyclonal antibodies** are also specific but are produced through conventional immunization, not the hybridoma technique. - The defining characteristic of the hybridoma technique is that it produces **monoclonal** (single clone) antibodies, not just "specific" ones. *Antigen* - An **antigen** is a molecule that elicits an immune response and is used to immunize animals during antibody production. - However, antigens are the **input** for antibody production, not the **product** of the hybridoma technique. *Cytokines* - **Cytokines** are signaling molecules involved in immune cell communication and regulation. - They are not produced by the hybridoma technique, which is specifically designed for **antibody production**.

Question 1009: What are the changes in the variable region of immunoglobulins?

A. Isotype
B. Epitope
C. Allotype
D. Idiotype (Correct Answer)

Explanation: ***Idiotype*** - **Idiotype** refers to the unique set of antigenic determinants in the **variable region** of an antibody molecule, specifically within the **hypervariable regions (complementarity-determining regions, CDRs)**. - These unique determinants allow antibodies to recognize specific antigens and are generated by the specific **V(D)J gene rearrangements** in B cells. *Isotype* - **Isotype** refers to the constant region of an antibody, determining its class (e.g., **IgG, IgM, IgA, IgD, IgE**). - This region defines the antibody's effector functions and has nothing to do with the antigen-binding variability. *Allotype* - **Allotype** refers to minor genetic variations within the **constant region** of an antibody molecule within a species. - These variations are due to different alleles inherited from parents and are not associated with the variable region that binds to antigens. *Epitope* - An **epitope** is the specific part of an **antigen** that an antibody or T-cell receptor recognizes and binds to. - It is a feature of the antigen, not a change within the variable region of the immunoglobulin itself.

Question 1010: What is the most common genetic factor associated with increased susceptibility to Neisseria infections?

A. HLA-B27
B. Complement deficiency (Correct Answer)
C. IgA deficiency
D. Factor H deficiency

Explanation: ***Complement deficiency*** - Deficiencies in the **terminal complement pathway (C5-C9)**, particularly C5b-C9 (membrane attack complex, MAC), significantly increase susceptibility to disseminated *Neisseria* infections. - The MAC is crucial for lysing Gram-negative bacteria like *Neisseria meningitidis* and *Neisseria gonorrhoeae*, and its absence allows for uncontrolled bacterial proliferation. *Factor H deficiency* - **Factor H** is a regulatory protein of the alternative complement pathway, preventing its overactivation on host cells. - Its deficiency typically leads to conditions like **atypical hemolytic uremic syndrome (aHUS)** and **dense deposit disease**, not primarily increased susceptibility to *Neisseria* infections. *HLA B27* - **HLA-B27** is a human leukocyte antigen strongly associated with a group of autoimmune inflammatory diseases called **spondyloarthropathies**, such as ankylosing spondylitis. - It does not directly impact the immune response to *Neisseria* infections or increase susceptibility to them. *IgA deficiency* - **Selective IgA deficiency** is the most common primary immunodeficiency, characterized by low or absent IgA levels. - Individuals with IgA deficiency are more prone to **recurrent respiratory and gastrointestinal infections**, but not specifically disseminated *Neisseria* infections.

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Cells and Organs of Immune System

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Innate Immunity

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Adaptive Immunity

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Antigens and Antibodies

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Major Histocompatibility Complex

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Complement System

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Cytokines and Chemokines

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Hypersensitivity Reactions

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Autoimmunity and Autoimmune Diseases

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Immunodeficiency Disorders

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Transplantation Immunology

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Tumor Immunology

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Immunology — MCQs

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