1) commitment to - gamma, delta - lineage of T cells occurs in which the following developmental stage: - DN -CD4+CD8+ DP - SP - mature nave T cell

l 2) What the difference between memory & nave cells: - Memory cells recirculate between blood & tissues, nave between blood & L.N. 3) IL-2 activates: - JAK5, STAT1 & STAT3 4) All of the following will not protect from tumor formation except (i.e. which one protects from tumors) a) CD8 cells reacting to tumor antigens [all other answers were the evasion mechanisms] - Introduction of tetanus toxoid is classified as immunity a) artificial active b) artificial passive c) natural active d) natural passive e) acquired active 5) Which of the following is mismatched a) IL-10 : mast cells b) IL-6 : Th2 cells 6) The mechanism that breakdown peripheral tolerance: - Molecular mimicry. 7) Autoantibodies bind a glycoprotein in the basement membrane of the lung & glomeruli this occur in: - Goodpasture's syndrome 8) C-ANCA: - Wegener's granulomatosis 9) The gene that cause cancer:

- Oncogene 10) DiGeorge syndrome is: - Monogenic 11) The disease that defect in actin cytoskeleton: - Wiskott-Aldrich syndrome 12) Promote transcription of HIV genes: - NF-Kb, NF-AT 13- not a cause of secondary immune deficiency : - Genetic mutation 14) the best place we can get stem cell from it: - Cord blood 15) the most challenge at Bone marrow transplantation: - graft versus host reaction GVHD- . 16) Cyclosporine & tacrolimus are: - T-cell signaling Blockade 17) Carcino-embryonic antigens are: - Developmental proteins 18) To increase the half-life of INF-a we add: - Polyethylene glycol (PEG) 19- Interlukein 12 is secreted from which cell: - Macrophage 20- complement defects lead to : - neisseria infections 21- What is the tissue typing technique that is used to detect antibodies against donor HLA : - HLA cross matching 23- cyclosporine acts on : - T Cell activation at calcinourea

24- The disadventage of using muse monoclonal antibodies : - the human body produces anti mouse antibodies 25 - the disease that improves during pregnancy is : - Multiple sclerosis - SLE 26 - the tendency to have IgE response is called: - Allergy - hypersensitivity -atopy 27- all are peripheral tolerance mechanisms except: T-cell killing in the thymus Cases : 28 - a boy was playing outside , days after he comes home he developed rash and irritation of the skin........................ , this type of hypersensitivity : - Delayed hypersensitivity contact dermatitis . 29 - a man 60 years old had a BM transplantation , the operation was successful , 2-3 days after the operation the man developed jundice ,diarrhea, hematouria the type of this rejection is : - hyperacute rejection - acute Graft-Versus- Host disease - chronic Graft-Versus- Host disease - chronic rejection 30 - a case about kidney disease , in the tests there was antibodies against glomerulus basement membrane : - Goodpasture syndrome.

31 case the lab test showed that the patient had c-ANCA, what's the diagnosis? Wegener's Granulomatosis. 32 - Which of the following is wrong about adjuvants a) they act as antigen depot b) they prolong the contact time with antigen

c) they make any molecule immunogenic d) they cause local inflammation 33 - AB+ child was born to an AB- mother, he had jaundice, fever and splenomegaly, direct coomb's test result will be: a) Anti-Rh antibodies bound to the mother's erythrocytes b) Anti-Rh antibodies bound to the infant's erythrocytes c) Anti-A and Anti-B in the infant's serum 34- RAG-1 and RAG-2 are downregulated in some stages of B-cell development, so th at each B cell will have only one specificity. The underlying mechanism is a) somatic hypermutation b) class switching c) affinity maturation d) allelic exclusion 35 - Aspirin mediates its effects through blocking the synthesis of a) leuktriens b) prostaglandins c) histamine 36 - A person had a rare pan-T-cell deficiency. On performing flow cytometry by the FACS machine, which cell marker will be the least in number ? a) CD19 b) CD3 c) CD5 d) CD11a 37 - Certain skin diseases are a result of high number of activated T cells. One hypothesis says that we can use the tetanus toxoid to fight these disease. Which of the following cytokines can give the best results if conjugated to the toxoid ? a) IL-2 b) TNF-alpha c) IL-4 d) IFN-gamma 38 -Which of the following cytokines will be most numerous in the brain of a patient with multiple sclerosis ? a) IL-2 and IFN-gamma

39 - [A case about rheumatoid arthritis] The patient has joint pain in the ankles, wrists. The rheumatoid factor in serum = 100 , ESR = (elevated). Which of the following antibodies mainly contributes to the pathogenesis of the disease ? a) IgM against IgG b) IgA against synovial cells c) IgM against histones d) IgG against dsDNA e) IgG against topoisomerase I enzyme. 40 - A patient has undergone stem cell transplantation. He didn't show any signs of rejection for 3 days, then he had some macular yellow rashes on the skin, with abnormal liver function test, abnormal creatinine, (many things!). What's most probably happening ? a) Hyperacute graft rejection b) acute graft rejection c) acute GVHD d)chronic GVHD e) chronic rejection 41 ) The disorder related to abnormal actin function is: a) Wiskot-Aldrich syndrome. - A patient with staphylococcal infection had normal IgM but low IgA, IgG levels in serum. Which of the following is deficient? a) CD(B7) b) CD80 c) CD40 d) CD40L 42 ) Ciclosporin and tacrolimus belong to which class of immunosuppressants ? a) antiprolirferatives b) IL-2 blockers c) T-cell signaling blockade d) corticosteroids 43 ) [A case about glomerulonephritis] the patient had elevated blood urea nitrogen, bronchospasm, reddish urine, the diagnosis was rapidly propagating glomerulonephritis. Which of the following is ture? a) there should be a lot of mast cells in the tissue b) there are antibodies reacting against tissue antigens 44) In cross-matching, we use: a)indirect coomb's test

b) direct coomb's test 45) All of the following are likely to induce tolerance except a) anatomic sequestration b) introduction of antigen during embryogenesis c) introduction of antigen to immature cells d) strong binding to autoantigen e) a pathogen binding to a self-antigen 46) All of the following are true about adjuvant EXCEPT: & All of the following are true about atopy EXCEPT: So you must focus in these terms .

46 ) Which drug will hopefully cause sterilizing immunity in HIV infection a) IL-7 b) IL-2 47 ) [a case] the patient had no lymphoid progenitorsWhich of these is likely to be abscent? Answer: IL-7 48) Which of the following has its only Fc portion from human origins a) humanized mAbs b) chimeric mAbs c) phage libraries 49) One method to increase the half-life of IFN-apha in the treatment of Hepatitis B is by PEGylation - The first thing to do when preparing for transplantation is to check a) major HLA compatibility b) minor HLA = c) ABO compatibility.

50) [a case]the patient had antibodies against the basement membrane of the kidney, what's your diagnoisis ? Goodpasture's syndrome -51 ) Which cell decides the polarization of adaptive immune response( to Th1 or Th2) is: a) APC b) nave T cell c)Tregs - 52) There were two questions about the association between Chronic granulomatous disease and the NBT test. - Which of the following can be produced from the MHC genes on the short arm of chromosome 6 a) complement C3 b) complement C5 - 53) a case about SCID. Which of the following is wrong? The patient's genes are normal. - 54) Monoclonal Abs that have the human constant region are called: - humanized - Chimeric -transgenic -55) Case: fever, dyspnea & hemoglobinuria,, the immunofleorescense test showed linear immune complex precipitation.. this type of autoimmune disease is mediated by: - soluble Ag against fixed Abs - stimulation of cells by autoantibodies - cell-mediated immunity & Granuloma formation -56) 9-year-old child with recuurent staphylococcal infection, differential CBC showed normal PMN count,, further tests will most likely show: - complement deficiency -low CD4+ cell count - -ve NBT test 57) autopsy of aborted fetus showed absent peripheral counts of T & B cells although his BM contained normal number of lymphoid precursors,, if deficiency in one IL-receptor was responsible for this case>> it's most likely to be: -IL-7

-IL-1 -IL-2 -IL-3 58) *the most informative sentence about mast cells: - they cause inflammation not only cuz of histamine release but also due to metabolism of A.A. 59) which cytokine can induce apoptosis: -IL-1 -IL-6 -TNF 60) which makes lymphocytes & neutrophils slow or stop at site of extravasation from blood vessels: - LFA-1 -ICAM-1 -VLA-4 61) needed for B cell stimulation: - cytokines & occupation of TCR - Ag & cytokines - TH cell & APC help 62) 2-year-old toddler suffering diarrhea, recurrent infections & failure to thrive.. his parents refused vaccines for religious reasons,, examinations revealed absent thymus gland; he has: - DiGeorge syndrome 63) Ags expressed in cancer & tissues from which they arise, belongs to which type of tumor Ags: - lineage-specific Ags 64) skin disorder characterized by over-activation of T-cells.. which cytokine is most likely to be used conjugated to diphtheria toxoid as a treatment for this case: - Inf- -IL-2 -IL-4 65) NADPH oxidase deficiency leads to deficiency in which cellular component:

- defensin -hypochlorus acid - lactoferrin -acidification of lysosymes 66) tumor Ags expressed in tissues during fetal life: - developmental Ags 67) Cyclosporin mech. Of Action: - intracellular signaling blockade 68) all true except: - Igs transported in the last month of pregnancy - Igs transported via specialized FcR in placenta - Igs are transported in energy-dependent mech.

69) case question: .. a defect in the hypochlorus acid this will affect : The acidity of the lysosmes 70) case question : so the patient is diagnosed with few T cell count, the site in the LN that is most likely to be affected the most? Paracortical area. 71) A boy was infected by tetanus infection , the doctor is not sure that he is protected from the tetanus so he give him a booster of tetanus toxoid this type of immunity is : )- artificially active immunity 72) he most common antibodies in the mucosal surface of the genital track?(from the first) IgA 73) the random addition of nucleotide by TdT is in ? (from the first) Junctional diversty 74) The change in the antigen binding site to create a higher affinity binding known as ?

Somatic hypermutaion 75 ) the child will use one chromosome from the parents chromosoms this is known as ( the question is not in this formula but the idea is this !!!)? Allelic exclusion.

76) one of the following is not correct about TI : ( not sure about the formula of the question) It has a memory 77) one of the following will not share in the synapse ? (from the first ) CD3 78 ) one of the following is not a responsibility of the anphlatoxins ????? I dont remember the choices sorry !!!!! 79) case question :. So he found that there are immune complexes in the kidney this an indication of : SLE 80) one of the following is not a cause of secondary immune deficiency ? Mutations 81) molecules produced by tumor cell and can be recognized by the immune system known as ? Tumor antigens From this to END FROM HAYAT AND SHIFA EXAMS : 82) Tumor correct except a) tyrosinase melanoma b) CEA & GI cancer c) Viral EBV Lymphoma d) BCR-Abl fusion protein multiple myeloma e) Alpha- feto protein hepatoma 83) HIV virus infects which cell? a) NK b) CD-8 c) B cell

d) Glial cell e) Basophile 84 ) Factor B a) Is the enzymatic part of the C3 convertase in the alternative pathway b) Only component of complement pathway that circulate active enzyme c) Bind covalently to pathogen through thioster bond d) Has no potential enzymatic activity e) Cleavage factor D 85 )mostly affected by INF type I (INF alpha and beta) a) Aspergellus b) Plasmodium c) Listeria bacteria d) Staphylococcus bacteria e) Influenza virus 86) The enzyme needed in liberation of HIV from infected cell a) Gp120 b) Protease c) Reverse transcriptase d) Integrase e) Collagenase 87)Active immunity cancer except a) Vaccination by tumor antigen b) BCG local injections c) Anti-CD20 infusion d) Vaccination by whole cell e) IL-2 infusion 88 ) serum sickness except a) C-factor b) Monovalent antigen c) Persistence immune complex d) Nutrophils e) Equivalence of antigen and antibody 89 ) viruses and malignancy except a) Human papilloma virus- cervical cancer b) EBV lymphoma c) Human herpes virus 8 and lymphoma d) HTLV-1 acute T lymph-leukemia

e) EBV nasopharyngeal 90) elimination of bacteria by opsonization a) neutralization of bacterial toxin b) recognition of bacteria bound antibodies by Fc receptor on macrophage c) prevention of bacteria adhesion to endothelial cell d) binding antibodies Fc on bacteria e) class 1 MHC antigen 91) recombination signal sequence best describes a) sequence that contain ITAM- signaling B cell b) sequence recognized by RAG1 RAG2 c) sequence responsible for type switching in B cell d) sequence encodes signal peptide responsible Ig e) sequence RNA splicing event IgM/IgD 92) MHC I and MHC II a) Constituvely expressed by most cells in the b) expressed by Macrophage and dentritic cell c) Constituvely associated hapten d) Expressed INF gamma 93) Injecting Complement C killing antigen-Ab in patient lacks C3 a) Depress level of serum factor B b) Increased chemotactic C5a serum level c) Increased serum level of C8 d) Decreased level of C2 94) Trophoblast . Immunological phenomenon except a) antibody against paternal antigens b) Increased HLA- G antigens c) Decreased MHC I d) Blocking antibody e) Increased CD8- T recognition 95) Which one is false? a) Mast cell : IL 12 b) TH2 : IL6 c) TH1 : INF gamma d) Eosinophil : IL 5

96) Regarding pregnancy, which is wrong? a) Androgen suppress T/B cells b) Estrogen suppress T cells c) Placenta TH1 suppress T cell d) NK cell suppressed by increased HLA-G 97) A 10 years old boy has recurrent skin and lung infections by staphylococcus aureus, what can be found at his diagnosis a) Low IgM, absence of B cell b) Low Ig low B cell c) Low terminal complement d) Abnormal NBT test 98) Pulmonary edema that follows incompatible transfusion results in a) Donor WBC antibodies against recipient granulocytes 99) During B-cell development the rearrangement in Ig loci a) DH to JH, DJ to VH, VL to JL 100) Activation of mature B cell requires two signals a) An antigen and T cell help b) TCR occupancy and T cell help??? c) Antigen and cytokines??? d) TCR occupancy and cytokines 101) The BM transplantation is the most difficult .. a) Hyperacute b) Acute rejections c) GVHD d) Tolerance 102) Macrophages secretes all except a) IL- 6 b) IL-8 c) INF gamma d) TNF alpha 103) Causes tolerance rather the immunity a) Insoluble antigen b) Heterologous antigen c) Particulate antigen d) Antigen injected subcutaneously

e) Injecting antigen to fetus in development 104 ) Autoimmune disease a) Shows HLA association b) Run a steady clinical course c) Affect both sexes equally d) are triggered by different antigen in different individuals 105) Cyclosporine A inhibits a) Calcinerium 106 ) Not used as an evading mechanism by viruses a) Mutation b) Production of cytotoxic Abs c) Downregulatin of MHC class I molecules d) Destroying the immune system 107 ) Which on is not involved in respiratory burst pathway of neutrophils killing a) PhospholipaseC gamma 108) Involved in stopping lymphocyte in HEV a) L-selectin b) LFA-1 109) Restriction means a) The recognition of self MHC with antigen by T cells 110) Which of the following is wrong regarding the fetus? a) Reversed num of pmn and lymphocytes b) No IgM, IgA, IgG 111) Complement activation a) Activate hapten b) Active C1q binds antigen-antibodycomplex c) C3 convertase C4bc2b d) C3 convertase C3bBb e) Regulate factor H ** The clinical boxes very important so you must focus on them.