Section 1

Immunology

1) From the most abundant to the least abundant immunoglobulin, which is CORRECT?

a) G, D, M, A, Eb) M, A, G, D, Ec) G, E, M, D, Ad) M, G, A, D, Ee) G, A, M, D, E

2) Regarding IgM, which statement is INCORRECT?

a) it is the first immunoglobulin to appear in the infantb) it exists as a pentamerc) it reaches adult levels by about one year of aged) it cannot be produced by the foetuse) it is the third most abundant immunoglobulin

3) Regarding IgG, which statement is INCORRECT?

a) it has a molecular weight of about 150,000b) it crosses the placentac) it accounts for most ABO blood group antibodiesd) it is the most commonly produced immunoglobulin in myelomae) it accounts for about 80% of all immunoglobulin

4) Regarding immunoglobulins, which statement is INCORRECT?

a) their classification is based on the heavy chains presentb) IgG is produced early in the primary immune responsec) chromosome 14 carries the gene for heavy chainsd) IgA is present in sero-mucus secretionse) the J-chain binds together two or more immunoglobulin monomers

5) Which of the following is NOT a major property conferring antigenicity?

a) negative chargeb) large molecular weightc) organic natured) protein structuree) polymeric structure

6) What percentage of lymphocytes are T cells?

a) 35% b) 40%c) 50%d) 65%e) 90%

7) Regarding CD4+ T cells:

a) they recognise antigens only in the context of MMCIIb) HIV infection raises the CD4 : CD8 ratioc) CD8 is expressed on more cells than CD4d) CD4 positive cells have little role other than as cytotoxic cellse) CD4 cells are formed by the equal cleavage of two CD8s or the binding of two CD2s

8) Which of the following is NOT an AIDS defining illness?

a) cervical intraepithelial neoplasiab) primary cerebral lymphomac) non-Hodgkin’s lymphomad) oral hairy carcinomae) Kaposi’s sarcoma

9) Which of the following is NOT an AIDS defining illness?

a) pneumocytosis carinii pneumoniab) cryptosporidium enteritisc) pulmonary tuberculosisd) cryptococcal meningitise) CMV encephalitis

10) Regarding the course of HIV infection, which statement is INCORRECT?

a) disappearance of persistent generalised lymphadenopathy (PGL) is a poor prognostic sign

b) viral replication occurs mainly within the spleen during period of asymptomatic infectionc) seroconversion illness usually occurs 2-4 weeks after viral transmissiond) primary cerebral lymphoma is usually a very late evente) up to 90% have central nervous system pathology at autopsy

11) Hypersensitivity reactions:

a) are not preventableb) can occur in response to exogenous and endogenous antigensc) include acute inflammationd) are never just localisede) fall into three categories

12) Goodpasture’s syndrome is an example of which form of hypersensitivity?

a) anaphylactic typeb) cytotoxic typec) immune complex diseased) cell mediated (delayed)e) none of the above

13) Regarding the structure of the HIV virion, which statement is INCORRECT?

a) core contains reverse transcriptaseb) envelope is composed of a spherical lipid bilayerc) core contains p24d) core contains one strand of single stranded RNAe) envelope is studded by glycoproteins, including gp120 and gp41

14) With respect to type II hypersensitivity, which is INCORRECT?

a) myasthenia gravis is one manifestationb) complement can be involvedc) macrophages can be involvedd) CD4 cells can be involvede) natural kill cells can be involved

15) Regarding immunodeficiency with predominantly T-cells defects, what is/are the most commonly associated infection(s)?

a) recurrent pyogenic infectionsb) pneumocystis carinii pneumoniac) viral infectionsd) candidiasise) tuberculosis

16) Regarding immunodeficiency with predominantly antibody defects, what is/are the most commonly associated infection(s):?

a) viral infectionsb) recurrent pyogenic infectionsc) giardiasisd) pneumocystis carinii pneumoniae) systemic fungal infections

17) Anticentromere antibodies are found in approximately 90% of patients with:

a) limited sclerodema – CRESTb) SLEc) sjogrens syndromed) systemic sclerosis – diffusee) inflammatory myopathies

18) Regarding type IV hypersensitivity, which statement is INCORRECT?

a) reactivity can be transferred from sensitised to non-sensitised individualb) maximal 48-72 hours after challengec) most cytotoxic T cells carry CD8+d) major effect of lymphokines is chemotaxis and activation of macrophagese) forms the basis of the lepromin test (Fernandez reaction)

19) Which of the following is NOT a cause of autoimmune disease?

a) molecular modificationb) molecular mimicryc) T cell suppressiond) bypass of T cell tolerancee) genetic factors

20) Regarding type III hypersensitivity, which statement is INCORRECT?

a) serum sickness occurs due to antigen excess in proportion to antibodyb) immune complexes bind to blood vessel walls and basement membranesc) arthus reaction is maximal at 4-8 hours after exposure to antigend) pigeon fancier’s lung is an example of an arthus reactione) jarisch-herxheimer reaction is an example of serum sickness

21) Regarding type II hypersensitivity, which statement is INCORRECT?

a) includes anti-receptor antibodies (formerly type V hypersensitivity)b) mediates some cases of graft rejectionc) involves the complement cascaded) receptor antibodies are usually IgMe) may be associated with diabetes mellitus

22) The body can defend itself against parasites by all of the following mechanisms EXCEPT:

a) innate immunityb) cell-mediated immunityc) humoral immunityd) antibody dependant cellular cytotoxicitye) action of eosinophils

23) Regarding type I hypersensitivity, which statement is INCORRECT?

a) IgE binds to both mast cells and basophilsb) “late phase reaction” occurs without additional exposure to antigenc) histamine causes more bronchospasm than SRS-Ad) up to 50% of atopic individuals have a positive family history of allergye) initial tissue response subsides within 60 minutes

24) Regarding type I hypersensitivity reactions, which of the following is NOT a secondary mediator?

a) SRS-Ab) trypsinc) leukotriene E4d) prostaglandin D2e) leukotriene B4

25) Regarding type I hypersensitivity reactions, which of the following is NOT preformed primary mediator?

a) platelet activating factorb) eosinophilc) histamined) neutrophil chemotactic factore) heparin

26) Which of the following is NOT a T cell subpopulation produced following exposure to an antigen?

a) inducer-helper cellsb) memory cellsc) lymphokine secreting cellsd) cytotoxic-suppressor cellse) natural kill cells

27) The most common blood transfusion reaction type is of:

a) type I hypersensitivityb) type II hypersensitivityc) type III hypersensitivityd) type IV hypersensitivitye) all of the above

28) Which of the following is NOT a mechanism by which antibodies directly attack an invader?

a) agglutinationb) precipitationc) neutralisationd) opsonisatione) lysis

29) Regarding the forces binding antigens to antibodies, which does NOT occur?

a) hydrogen bondingb) ionic forces c) covalent bondingd) Van der Waals forcese) hydrophobic bonding

30) Regarding IgE, which statement is INCORRECT?

a) mediates type I hypersensitivity reactionsb) increased amounts present in fungal infectionsc) molecular weight of about 200,000d) allergens cause cross-linkage of IgE molecules

e) least abundant immunoglobulin

31) Regarding IgA, which statement is INCORRECT?

a) exists as a monomerb) accounts for about 13% of all Igc) reaches adult levels by age 10 to 14 yearsd) second most abundant Ige) plays an important innate immunity role in the respiratory tract

32) Eosinophils:

a) make up 30% of all leukocytesb) play a role on parasitic infectionsc) are responsible for releasing histamine in type I hypersensitivity reactionsd) are strongly phagocytice) become plasma cells in the extravascular space

33) In HIV infection:

a) transmission is only via sexual contact or parenteral inoculation b) AIDS is recognised when there is a specified secondary infection or malignant

neoplasmc) IV drug users constitute the largest group with HIV infection in the USAd) CD4 cells offer no predictive value in determining the subsequent development of

AIDSe) Kaposi’s sarcoma is more common in IV drug users than in homosexuals

34) In a healthy individual over the age of 5 years, lymphocytes are mainly found in:

a) bone marrow, thymus, spleenb) liver, thymus, spleenc) lymph nodes, spleen, thymusd) bone marrow, spleen, livere) liver, spleen, pancreas

35) Blood transfusion reaction is an example of which type of hypersensitivity reaction?

a) type Ib) type IIc) type IIId) type IV and III

e) none of the above

36) With regard to natural killer lymphocytes:

a) they constitute less than 5% of blood lymphocytesb) they require opsonisation to enable their killing of cellsc) they have a prime role in defence against parasitesd) they require prior sensitisation to be effectivee) they have an innate ability to lyse tumour cells and virally affected cells

37) An anaphylactoid reaction:

a) is a localised form of an anaphylactic reactionb) is an example of an immune complex mediated reaction (type III hypersensitivity)c) occurs without prior sensitisation to an antigend) does not involve the release of histamine from mast cellse) results from IgE mediated mechanisms

38) With regard to B lymphocytes:

a) they constitute 50% of circulating lymphocytesb) they are found in germinal centres in the red pulp of the spleenc) they are genetically programmed to recognise specific antigens by means of antigen

specific cell surface receptorsd) they release chemical mediators when attached to IgE in type I hypersensitivity

reactionse) they are not affected by HIV infection

39) MHC class I molecules are:

a) co-receptors on the CD8 moleculeb) co-receptors to the CD4 moleculec) present on T lymphocytes onlyd) couples to peptide products of extracellular antigense) identical in fraternal twins

40) Transplant rejection involves:

a) type IV hypersensitivity onlyb) type IV and III hypersensitivity onlyc) type IV, III and II hypersensitivity onlyd) type IV and II hypersensitivity onlye) type II and III hypersensitivity only

41) With respect to macrophages, which of the following is NOT true?

a) they can produce TNF and IL-4 both of which cause feverb) they have direct tissue toxicity due to the ability to release hydrogen peroxidec) they have oxygen dependent mibrobicidal activityd) they have cytotoxicity against tumour cellse) they process antigens and act as antigen presenting cells to activate lymphocytes

42) With regard to Langerhan’s cells in the immune system, which of the following is NOT true?

a) they are dendritic cellsb) they possess large numbers of cell surface class II moleculesc) they are found primarily in the epidermisd) they are strongly phagocytice) they are involved in delayed hypersensitivity reactions

43) Regarding the complement system:

a) complement factors D and B are crucial to activation of the classical pathwayb) polysaccharide molecules on bacterial cell membranes can activate the classical

pathwayc) enzyme precursors of the complement system are released by activated macrophagesd) activation of the classical pathway occurs as a result of the antigen – antibody reactione) when the alternative pathway is activated, fragments C3a, C4a and C5a are NOT

produced

44) Which of the following are phagocytic?

a) CF4 and helper T cellsb) natural killer cellsc) CD8 and cytotoxic T cellsd) all of the abovee) none of the above

45) Monocytes:

a) have a half-life of 6 hours in plasmab) have a cytoplasm containing biologically active granulesc) may convert to mast cellsd) may convert to kupffer cells in the liver

e) undergo cell division under the influence of erythropoietin

46) Poison ivy dermatitis is an example of:

a) type I hypersensitivityb) type II hypersensitivityc) type III hypersensitivityd) type IV hypersensitivitye) none of the above

47) With regard to T lymphocytes:

a) plasma cells are activated by T lymphocytesb) T cells become activated on binding to free antigenc) normally, 60% of T cells bear the cell marker CD8+d) CD4+ T cells are MHC class II restrictede) T helper I cells primarily secrete IL-4 and IL-5

48) With regard to IgE:

a) it exists as a hexamer in bloodb) it is the least common immunoglobulin in the blood streamc) it is mainly found in tears and mucosal secretionsd) it is produced by T lymphocytese) it can initiate complement fixation once bound to antigen

49) With regard to patients with AIDS, which of the following is NOT true?

a) P. carinii pneumonia is the presenting feature in approximately 50% of casesb) CD4+ T cell counts in blood are reasonably accurate prognosticatorsc) Kaposi’s sarcoma is the most common neoplasm seen in AIDS patientsd) decreased humoral immunity increases the risk of recurrent bacterial pneumonias e) titres of HIV fall as CD4+ T cell counts fall

50) With respect to the complement system:

a) it can only be activated once an antibody binds to an antigenb) it is inhibited by polyfructose in bacterial cell membranec) its activation can result in pore forming molecules being inserted into target cell

membranesd) is activated by sites on the variable portion of IgG immunoglobulin e) it inhibits granulocyte release from neutrophils

51) Successful immune response to HIV during the acute phase of infection results from:

a) increase in the CD4+ lymphocyte numbersb) appearance of anti-HIV antibodiesc) type III hypersensitivity reactiond) lymphoid tissue based destruction of infected cellse) development of CD8+ virus specific cytotoxic cells

52) With regard to the transmission of HIV infection, which of the following is NOT true?

a) risk of seroconversion from a needlestick injury from a HIV positive patient is approximately 30%

b) heterosexual transmission is the dominant mode of HIV infection in Asiac) female-male sexual transmission is about half as efficient as male-female spreadd) the rate of vertical transmission from mother to child is less than 50%e) all of the above are true

53) Cytokines:

a) are usually only produced by one cell typeb) activate a large number of immunocompetent cells because they do not require

specific receptorsc) have narrow ranges of action and specific effects because of the high-affinity receptors

on target cellsd) such as IL-Z are crucial to graft vs host reactionse) do not produce effects in the cell-type that secretes them

54) Which of the following is TRUE of a healthy adult?

a) T lymphocytes constitute 40% of peripheral lymphocytesb) CD4++ T lymphocytes are directly cytotoxicc) B lymphocytes constitute 15% of peripheral lymphocytesd) NK cells are characterised by CD3 and CD16 surface moleculese) B lymphocytes are characterised by CD3 and IgM surface molecules

55) Concerning hypersensitivity:

a) type II reactions depend upon activation of phagocytic cellsb) eosinophils are predominant in type I early phase reactionsc) type III reactions are less likely in conditions of antibody excessd) leukotrienes are released by mast cells as preformed mediators of type I reactions

e) Grave’s disease is a good example of type III reactions

56) Organ transplant rejection reactions:

a) are predominantly type II hypersensitivity reactionsb) are characterised by acute rejection vasculitis which occur in the first few months

following transplantationc) are usually directed against organ parenchymad) most commonly demonstrate an acute vasculitic reactions, known as “acute rejection

vasculitis”e) are restricted to the transplanted organ

57) Mononuclear phagocytes:

a) are the predominant cells in three day old woundsb) are common in liver, spleen and pancreasc) produce fibroblast growth factord) secrete interferon Ye) have a half-life of one day

58) The following are primary mediators of type I hypersensitivity reactions EXCEPT:

a) adenosineb) neutrophil chemotactic factorc) heparind) platelet activating factore) acid hydrolases

59) Type I hypersensitivity:

a) involves sensitised T lymphocytesb) involves phagocytosis of target cells by activated macrophagesc) involves formation of cytotropic (IgE) antibodyd) histamine is a secondary mediatore) proteases are secondary mediators

Section 1

Immunology – Answers

1 E2 D3 C4 B5 A6 D7 A8 D9 C10 B11 B12 B13 D14 D15 C16 B17 A18 A19 C20 E21 D22 C23 C24 B25 A26 E27 C28 D29 C30 B31 A32 B33 B34 C35 B36 E37 C38 C39 A40 C41 A42 D

43 D44 E45 D46 D47 D48 E49 E50 C51 E52 A53 D54 C55 C56 B57 C58 D59 C

Section 2

Immune System

1) Which of the following is correct regarding T lymphocytes?

a) in the blood T cells constitute 50% of peripheral lymphocytesb) CD8-CD4 ratio in normal healthy persons is 2:1c) CD4 molecules bind to class 1 MHC moleculesd) The TH subset of CD4+ T cells synthesizes and secretes IL-2 and IFN-γe) CD4+ T cells act primarily as cytotoxic cells

2) Which of the following is correct?

a) dendritic cells are confined to the lymphoid tissueb) B cells cannot be activated by soluble antigensc) The TH2 subset of CD4+ T cells secrete cytokines facilitating macrophage-dependent

immune responsesd) natural killer cells are CD3+

e) natural killer cells can lyse some virally infected cells without prior sensitisation

3) Ankylosing spondylitis is associated with the HLA type:

a) DR3b) DR4c) A3d) BW47e) B27

4) Transplant rejection is an example of primarily which type of hypersensitivity reaction?

a) anaphylactic typeb) cytotoxic typec) immune complex diseased) cell mediated hypersensitivitye) none of the above

5) Type I hypersensitivity reactions are mediated by formation of which immunoglobulin?

a) IgGb) IgAc) IgEd) IgMe) Igor

6) Mast cells can be activated by:

a) IgEb) C5ac) C3ad) all of the abovee) none of the above

7) Which immune cell does NOT act predominantly by phagocytosis?

a) eosinophilsb) monocytesc) lymphocytesd) neutrophilse) basophils

8) Lymphocytes comprise what percent of the white blood count in normal blood?

a) 5%b) 2.3%c) 30%d) 62%e) 0.4%

9) Which is TRUE?

a) the majority of the body’s lymphocytes are in circulation at any one timeb) granulocytes are formed in bone marrow and spleenc) there is a months store of WBC in bone marrowd) monocytes are only formed in bone marrowe) megakaryocytes are formed in lymphoid tissue

10) Which has the shortest lifespan in the absence of severe infection?

a) lymphocytes in tissuesb) macrophages in tissuesc) granulocytes in tissuesd) monocytes in blood e) granulocytes in blood

11) Which is most effecting against invading bacteria?

a) eosinophilsb) macrophagesc) monocytesd) basophilse) neutrophils

12) The reticuloendothelial system refers to:

a) the monocyte-macrophage systemb) the tissue-fixed macrophage populationc) the granulocyte development systemd) the lymphocyte recirculating system

13) Regarding eosinophils:

a) they are strongly phagocytic of parasitesb) do not respond to chemotactic signalsc) are attracted to allergic tissues by macrophage released inflammatory mediatorsd) ingest and destroy allergen-antibody complexes in allergic tissue

14) Regarding lymphocytes:

a) T cells are preprocessed in the thymus, removal of which diminishes but not abolishes T cell immunity

b) B cells are entirely preprocessed in the bone marrow during foetal lifec) T cells have greater antigenic diversity than the B cell populationd) T cells are responsible for humoral immunity

15) Regarding T lymphocytes:

a) they produce antibodies when stimulatedb) T-suppressor cells are the most abundant subgroupc) release lymphokines from T-helper cellsd) interferon γ is a potent amplifier of cytotoxic and suppressor T cell productione) constitute 40% of lymphocytes

16) The T cell recognition complex:

a) in the majority of cells is a heterodimer of a γ/δ polypeptideb) is associated with the CD4/CD8 complex which is constant but acts in transduction of

signal from the TCRc) CD8 T cells are the target of the HIV virus, the cells have mainly cytotoxic functionsd) CD4 molecules are co-receptors that recognise MHC II complexes on target cells

17) Which is NOT an Ag-presenting cell?

a) neutrophilsb) macrophagesc) dendritic cellsd) Langerhan’s cell

18) Regarding hypersensitivity:

a) all type I reactions are IgE mediatedb) basophils act in a similar manner to mast cells and are found near blood vessels,

nerves and subepithelial sites where type I reactions are likely to occurc) type I reactions are mediated via CD4+ T-helper cells which is required at the initial

exposure for IgE production

19) Which inflammatory mediator is more abundant in the initial transition phase of type I hypersensitivity than in the late phase?

a) platelet activating factorb) histaminec) major basic proteind) TNF α

20) Which is a type II complement-dependent hypersensitivity reaction?

a) bee sting allergyb) post streptococcal glomerulonephritisc) arthus reactiond) erythromblastosis foetalise) myasthenia gravis

21) Which is a hypersensitivity reaction as a result of localised Ag-Ab complex formation?

a) type II localised reactionb) arthus reactionc) tuberculin reactiond) type IV hypersensitivity

22) Which cell type is responsible for hyperacute graft rejection:

a) B-cellsb) T cells CD4+

c) T cells CD8+

d) macrophages

23) In the western world:

a) HIV-I is less prevalent than HIV-2b) IV drug use constitutes the highest rate of mode of transmissionc) increased rates of sexual transmission are seen in patients with other STDsd) seroconversion after accidental needlestick injury is 1% lower than for hepatitis B

24) In HIV:

a) macrophages and monocytes are refractory to HIV cytopathic effects and play little role in viral pathogenesis

b) viral lipid coat glycoprotein GP41 acts as the antigen for CD8 on T-cells allowing viral entry

c) after internalisation into the T cell the virus causes rapid onset lysis causing a depletion in CD4 count

d) T cell memory is lost early in AIDS

Section 2

Immune System – Answers

1 D2 E3 E4 D5 C6 D7 C8 C9 D10 E11 B12 A13 D14 A15 C16 D17 A18 C19 B20 D21 B22 A23 C24 D

Section 3

1) SCID – all are true EXCEPT:

a) is due to a T cell differentiation defectb) most commonly is X-linkedc) presents with oral candidiasis, diaper rash and failure to thrived) without bone marrow transplantation, death occurs within one yeare) lymphoid tissue is hypoplastic and the thymus is small and devoid of lymphoid cells

2) Sjogren syndrome is characterised by - which is FALSE:

a) also known as sicco syndromeb) xerostomiac) most commonly associated with thyroiditisd) keratoconjunctivitis siccae) lymphocyte infiltration of lachrymal and salivary glands

3) AIDS – which is TRUE:

a) heterosexual transmission is now the dominant mode of transmission in Americab) cell mediated immunosuppression is the hallmark of AIDSc) associated with severe loss of CD8+ T cellsd) macrophages and dendritic cells are not targeted by HIV infectione) histioplasmosis is the most common fungal infection in patients with HIV

4) Which is true for hypersensitivity reactions?

a) in type I formation of IgG antibody results in histamine release from basophilsb) an example of a type II reaction is erythroblastosis foetalisc) in type III IgG or IgM binds to antigen or target cells and res?????? in phagocytosis or

cell lysisd) in cell-mediated hypersensitivity, sensitised B-cells produce a granulomatous reactione) all the above are true

Section 3

1 A2 C3 B4 B

Section 4

Immunity

1) Which is a secondary mediator in type I hypersensitivity?

a) histamineb) eosinophil chemotactic factorsc) platelet activating factord) neutral proteasese) heparin

2) Acute serum sickness is what type of hypersensitivity reaction?

a) type Ib) type IIc) type IIId) type IVe) type V

3) How long after initial antigen administration does the acute inflammatory reaction of serum sickness occur?

a) 1 dayb) 2 daysc) 5 daysd) 10 dayse) 20 days

4) An example of a type IV hypersensitivity reaction is?

a) hayfeverb) transplant rejectionc) Good Pasture syndromed) arthus reactione) SLE

5) Regarding HIV infection:

a) HIV-2 is the most common subtypeb) CD8 molecule is a high affinity receptor for HIVc) HIV is carried to the brain by infected T lymphocytesd) 50-70% will be symptomatic in the early acute phase

e) pulmonary tuberculosis is a sign of AIDS

6) Regarding B lymphocytes:

a) constitute 40% of peripheral lymphocytesb) found in the red pulp of the spleenc) bind antigens by IgM on the cell surfaced) are not infected by Epstein-Barr viruse) influence the function of virtually all other cells of the immune system

7) Which is the most common manifestation of SLE?

a) haematologicb) arthritisc) skind) renale) pericarditis

8) Which is an abnormality of immune function in AIDS?

a) increased CD4:CD8 ratiob) hypogammaglobulinaemiac) increased delayed-type hypersensitivityd) decreased spontaneous secretion of IL-1, TNF-6 and IL-6e) decreased chemotaxis and phagocytosis

9) Which neoplasm is NOT associated with AIDS?

a) cervical carcinomab) Kaposi sarcomac) non-Hodgkin lymphomad) primary cerebral lymphomae) testicular seminoma

10) In type I hypersensitivity:

a) heparin is a secondary mediatorb) eosinophils are not involvedc) there is a familial predispositiond) it is mediated by IgG and IgM antibodiese) tissue basophils play a role

Section 4

Immunity – Answers

1 C2 C3 D4 B5 D6 C7 A8 E9 E10 C

Section 5

1) Regarding hypersensitivity disorders, which is correctly paired?

a) type I – IgM formationb) type II – sensitised T lymphocytesc) type III – antibody/antigen complexesd) type IV – IgE formatione) transplant rejection – IgG formation

2) In anaphylaxis:

a) histamine is the most potent vasoactive agentb) secondary mediators are stored with mast cell granulesc) synthesis of IgE is dependent on TH2 helper cellsd) leukocyte infiltration occurs during initial responsee) prostaglandin D2 is the most abundant primary mediator

3) Histamine:

a) is rapidly synthesised and released in acute inflammationb) is stored in plateletsc) causes arteriolar constrictiond) acts on the microcirculation mainly via H2 receptorse) release is inhibited by C3a and C5a

4) Inhibitors of the complement cascade include:

a) collectinsb) properidin Pc) MACd) DAFe) C5 convertase

5) Activated Hagerman factor (XIIa) initiates all EXCEPT:

a) prostaglandin generationb) kinin systemc) coagulation cascaded) complement activatione) production of plasmin

6) Regarding cellular mediators, which is CORRECT?

Mediator Sourcea) nitric oxide mast cellsb) serotonin all leukocytesc) lysosomal enzymes macrophages onlyd) prostaglandins all leukocytes and plateletse) PAF platelets

7) Regarding arachidonic acid metabolism:

a) ????? lipoxygenase is inhibited by glucocorticoidsb) thromboxane A2 inhibitis platelet aggregationc) leukotriene B4 is a potent chemotactic agentd) prostaglandin D2, E2, and F2 cause bronchospasme) prostacyclin is a vasoconstrictor

8) Chronic inflammation is characterised by all EXCEPT:

a) mononuclear cell infiltrationb) fibrosisc) angiogenesisd) oedemae) tissue destruction

9) Macrophages release:

a) growth factorsb) elastasesc) complement componentsd) nitric oxidee) all of the above

(No answers to these questions – just page references)