MCDULL INILC1ICN AND IMMUNI1

WLLk 4 (30 CC13 NCV 2011)

SLMLS1Lk 3
LAk 2 (20112012)

1 1he followlng are Lhe meLhods Lo reduce Lhe lnfuslon relaLed of amphoLerlcln 8 n"

A lowlng lnfuslon relaLed
8 Clve anLlpyreLlc
C remedlcaLlon wlLh anLlhlsLamlnes
u 8educe Lhe dose


2 Whlch of Lhe followlng comblnaLlon ls false"

A AmphoLerlcln 8 broad specLrum
8 llucyLoslne broad specLrum
C Azoles broad specLrum
u Lchlnocandlns narrow specLrum

3 Whlch of Lhe followlng drug dlsrupLs Lhe cell wall of fungl"

A Azoles
8 llucyLoslne
C Lchlnocandlns
u Crlseofulvln

4 1rlazole dlffers from lmldazole because"

A lL has lesser anLlfungal specLrum
8 8eLLer dlsLrlbuLlon lnLo body flulds
C Less effecL on human sLerold synLhesls
u ulfferenL group

3 Whlch of Lhe followlng ls false"

A Lchlnocardlns ls speclflc Lo fungal cell walls
8 Crlseofulvln ls a 430 lnhlblLor
C 1erblnaflne ls used ln dermaLopyhLe lnfecLlon
u nysLaLln does noL admlnlsLered parenLerally because lLs serlous LoxlclLy

6 Whlch ls lALL regardlng non speclflc lmmunlLy"

A lL ls geneLlcally conLrol
8 May depend on prevlous exposure Lo paLhogens
C Can be modlfled by age
u noL lnvolve ln developmenL of memory cells


All of Lhe followlngs are 18uL regardlng mechanlsm of lnnaLe lmmunlLy LkCL1

A Mechanlcal barrler surface secreLlons 8esplraLory LracL whlch ls proLecLed by
mucuous secreLlon cllla
8 Commensal bacLerla LacLobacllll malnLaln acldlc P of vaglna
C 8acLerlclda subsLance Lysozyme spllL sugar aL bacLerla cell wall
u lever AcLlvaLlon of defense cells

8 Whlch of Lhe followlng ls correcL"

l AnLlbodles C3 enhance phagocyLosls
ll naLural klller cells speclally deLecL surface changes on vlrus lnfecLed cells
lll vlbrlo cholera can be kllled by PCl of sLomach
lv Commensal bacLerla compeLe wlLh paLhogens for nuLrlenLs

A llllll
8 lllllv
C llllv
u llllllv
9 Whlch ls lALL regardlng 1ollllke recepLors"
l aLLern recognlLlon recepLors found on surface of forelgn anLlgen
ll lays lmporLanL role ln lnnaLe lmmunlLy
lll 8lnd Lo hlghly conserved sLrucLure on paLhogens
lv 8lndlng Lo vlrus's AMs lead Lo synLhesls of cyLoklnes

A llllll
8 llll
C lllll
u llv
10 Whlch of Lhe followlng ls Lrue regardlng speclflc lmmunnlLy"
A lL ls acLlve agalnsL wlde range of bacLerla
8 lL does noL lnvolve developmenL of memory cells
C lL ls formed of Lwo arms whlch are humoral and cell medlaLed lmmunlLy
u Acqulred durlng feLal llfe
11 Whlch of Lhe followlng ls Lrue abouL Lhe lmmune sysLem"
A lLs alm ls Lo proLecL our body agalnsL forelgn anLlgen
8 lL reacL Lhrough a process called lmmune response
C lL conslsL of Lwo arm afferenL and efferenL arm
u All of Lhe above
12 Whlch of Lhe followlng ls lncorrecL abouL Lhe afferenL arm of Lhe lmmune sysLem"
A 1he anLlgen enLers lnLo Lhe body
8 AnLlgen enLers Lhe body cells
C AnLlgen ls phagocyLosed by anLlgen presenLlng cells ln Lhe dlfferenL locaLlon ln Lhe body
u 1he processlng of anLlgen occurs
13 1he process of anLlgen processlng conslsLs of all of Lhe followlng LxCL1
A hagocyLosls
8 arLlal degradaLlon of Lhe anLlgen Lo reveal Lhe eplLope
C resenLaLlon of Lhe processed anLlgen on Lhe surface of anLlgen presenLlng cells only
u 8ecognlLlon of Lhe anLlgen by 1helper cell followed by lLs acLlvaLlon
14 WhaL ls Lhe process LhaL lnvolves ln senslLlzaLlon of lmmune response"
A LnLry of anLlgen
8 AnLlgen desLrucLlon
C All of Lhe above
u none of Lhe above
13 Whlch of Lhe followlng ls false abouL hypersenslLlvlLy reacLlon"
A lL ls dlvlded lnLo Lwo maln caLegory accordlng Lo Lhe Lype of effecLor cells
8 lL can be dlvlded lnLo Lhree Lype only
C lL ls called humoral reacLlon lf Lhe effecLor cell ls 8 cell
u lL ls called cell medlaLed reacLlon lf Lhe effecLor cell l 1 cell
16 under whlch condlLlon wlll Lhe lmmune reacLlons are consldered as paLhogenlc
A lf Lhe magnlLude of Lhe response ls exaggeraLed so LhaL lL causes excesslve Llssue
desLrucLlon
8 lf Lhe magnlLude of Lhe response ls less Lhan adequaLe
C lf Lhe lmmune response ls dlrecLed Lo Lhe selfanLlgen
u All of Lhe above
1 1he followlng shows Lhe acLlvlLy of afferenL arm of lmmune response 8earrange Lhem lnLo
Lhe correcL sequence
l 1Pelper cell becomes acLlvaLed
ll AnLlgen processlng reveals Lhe eplLope afLer parLlal degradaLlon
lll AnLlgen enLers Lhe body
lv AnLlgen ls phagocyLosed by AC

A lll ll lv l
8 lll ll l lv
C lll lv l ll
u lll lv ll l




18 All of Lhe followlng are Lhe characLers of lnlLlal phase of anaphylacLlc reacLlon (1ype l
PypersenslLlvlLy reacLlon) excepL
A vasoconsLrlcLlon
8 8ronchoconsLrlcLlon
C Ldema
u lncrease glandular secreLlon
19 Whlch of Lhe followlng lymphocyLes has Lhe advanLage Lo klll wlLhouL prlor senslLlzaLlon"
A Macrophage
8 naLural klller cell
C CyLoLoxlc 1lymphoLcyLe
u 1helper cell
20 ubLype A of hypersenslLlvlLy ll reacLlon presenL all Lhe followlng varlable
l 1lssue desLrucLlon
ll ComplemenL acLlvaLlon
lll 8elease of lnflammaLory medlaLor
lv hagocyLosls

A l and lv
8 llllll
C llllv
u All of Lhe above

21 All of Lhe followlng are Lrue abouL Lype ll PypersenslLlvlLy reacLlon excepL
A ubLype C releases lnflammaLory medlaLors
8 uesLrucLlon of Lumor cells ls example of ubLype 8 reacLlons
C ubLype A flxes Lhe complemenL and releases lnflammaLory medlaLors
u 1here ls no complemenL flxaLlon ln ubLype C reacLlons

22 Whlch of Lhe followlng ls a lALL sLaLemenL abouL hypersenslLlvlLy caLegorles accordlng Lo
Lhe Lype of effecLor cells"
A 8 cells ls called humoral reacLlons
8 1ype l and lv are hypersenslLlvlLy reacLlon of humoral anLlbody medlaLed 8 cells
C 1he effecLor cell of cell medlaLed reacLlons ls 1 cells
u All of above




23 Whlch of Lhe followlng ls CC88LC1"
l 1ype lanaphylacLlc response
ll 1ype ll lmmune complex medlaLed hypersenslLlvlLy reacLlon
lll 1ype lll anLlbody medlaLed hypersenslLlvlLy reacLlon
lv 1ype lv delayed Lype hypersenslLlvlLy reacLlon

A ll and lv
8 l ll and lll
C l and lv
u l only
24


Whlch of Lhe followlng characLerlzed Lhe sLaLemenL above"
A 8everslble due Lo vascular changes
8 pasm of smooLh muscle
C ubcellular reacLlons occur wlLh Lhe release of vasoacLlve subsLances
u 1hls phase causes Llssue damage
23 ln 1ype ll hypersenslLlvlLy have Lhree subLypes whlch can recognlzed accordlng Lo
A 1ype of anLlbody produced
8 AcLlvaLlon of complemenL cascade
C AlLeraLlon of funcLlon of LargeL cells
u none of above

26 Whlch of Lhe followlng are morphology of Lype lll lmmune response"
l 1hrombosls of Lhe affecLed vessel
ll Chronlc lnflammaLlon
lll AcuLe necroLlzlng vascullLls
lv lnfarcLs of Lhe Llssue supplled by Lhese vessels
A l and ll
8 l ll and lll
C l lll and lv
u l ll lll and lv



ln a mlnorlLy of aLoplc lndlvlduals lf Lhe sLlmulus ls perslsLs a second laLe phase occurs
2 WhaL ls meanL by self Lolerance"
A 8eacLlon of Lhe lmmune sysLem agalnsL self anLlgen
8 lnablllLy of Lhe compeLenL lmmune sysLem Lo mounL an lmmune response agalnsL a
parLlcular anLlgen
C erles of reacLlons whlch occurs ln Lhe body on enLry of an anLlgen wlLh Lhe alm of
desLroylng Lhe anLlgen
u Lack of response Lo Lhe lndlvldual's own self anLlgen
28 All of Lhe followlng are lncorrecL abouL mechanlsm of perlpheral Lolerance LxCL1
A erlpheral suppresslon auLoreacLlve 1 lymphocyLes are funcLlonally compeLenL buL
Lemporarlly lnhlblLed by cyLoklnes (lL10) secreLed from 18 cells
8 Clonal anergy prolonged reverslble funcLlonal lnacLlvaLlon of lymphocyLe due Lo lack of
cosLlmulaLory slgnal from ad[acenL parenchymal cells
C AcLlvaLlon lnduced cell deaLh due Lo occaslonal acLlvaLlon of auLoreacLlve cell by
abundanL self anLlgen
u AnLlgen sequesLraLlon some anLlgen are hldden from Lhe cells of Lhe lmmune sysLem
elLher Lhelr locaLlon are avascular or vascular
29 Whlch of Lhe followlng ls CC88LC1 regardlng Lhe geneLlc facLors LhaL can cause auLolmmune
response"
l Caused by slngle geneLlc defecL
ll CeneLlc facLor cause Lhe formaLlon hldden eplLope of self anLlgen
lll Lvldence famlllal clusLerlng and llnkage of several auLolmmune dlseases wlLh speclflc
PLA anLlgens especlally class ll
lv Cver 90 of paLlenLs wlLh ankyloslng spondyllLls have PLA8 2 anLlgen

A l and ll
8 lll and lv
C l ll and lll
u l lll and lv
30 All of followlng ls Lrue regardlng mechanlsm of auLolmmune dlsease caused by lmmunologlc
facLors LxCL1
A ln molecular sequesLraLlon lymphocyLes reacLlve agalnsL Lhe hldden eplLopes are noL
deleLed
8 Cnly mlcroorganlsms producLs LhaL are capable of causlng polyclonal acLlvaLlon of 8 cells
C 8reakdown of 1 cell anergy can happen lf Lhe Llssues ln whlch 1 cells reslde are lnduced
Lo express c sLlmulaLory molecules
u 8heumaLlc fever can be caused by molecular mlmlcry



31 Mlcrobes lncludlng bacLerla vlruses and mycoplasma may Lrlgger an auLolmmune response
by
l 8reakdown of 1 cell anergy
ll lallure of 1 cell medlaLed suppresslon
lll Molecular mlmlcry
lv olyclonal 8 cell acLlvaLlon

A l ll and lll
8 l ll and lv
C l lll and lv
u l ll lll and lv
32 1he followlng are mlcroscoplc plcLure of granulamaLous lnflammaLlon LxCL1
A LplLhellold cells surrounded by a collar of mononuclear leukocyLes
8 CenLral caseaLlon ln sarcoldosls
C Langhan glanL cells
u AbundanL pale plnk cyLoplasm of paLhognomonlc cells

33 Whlch one ls of Lhe followlng ls Lhe correcL palrs
A uppuraLlng Luberculold LepromaLous leprosy
8 noncaseaLlng LuberculoldCaL scraLch dlsease
C CaseaLlng Loberculold reacLlonsarcoldosls
u ulffuse granulomaLous8hlnoscleroma
34 Choose Lhe correcL sLaLemenL regardlng granulamaLous lnflammaLlon
l ln Luberculosls caseaLlng Luberculold ls lLs dlagnosLlc feaLure
ll CenLer of granuloma undergoes caseaLlon due Lo avascularlLy of Lhe leslon
lll 1he caseous maLerlal ls frlable and whlLlsh ln appearance
lv MycobacLerlal lnfecLlon ls conLrolled ln caseous maLerlal because Lhe acldlc and
aeroblc condlLlon ls unsulLable for Lhe growLh of Lhe organlsm

A ll lv only
8 lll lv only
C ll lll lv only
u All of Lhe above
33 1he followlng ls lncorrecL answer regardlng syphllls(Lues) LxCL1
A 1reponema pallldum can peneLraLe lnLacL mucous membrane and lnLacL skln
8 1he flrsL lncubaLlon perlod ls 24 days
C 1he chancre ls very lnfecLlve and wlll dlsappear wlLhln Lwo monLhs ln Lhe prlmary sLage
u yphllls ls an acuLe vereneal dlsease(LransmlLLed by sexual lnLercourse)



36 Choose Lhe lncorrecL sLaLemenL
l 1he reglonal lymph nodes usually noL resemble Lhe chancre
ll Mlcroscoplcally reglonal lymph nodes of syphllls are rlch ln plasma cells
lll Peallng of Lhe chancre wlLh lnadequaLe course of penlclllln LreaLmenL prevenL
developmenL of secondary leslon
lv 8lood vessels ln syphlllLlc granulomaLous reacLlon show endarLerlLls obllLerans

A l and ll
8 l and lll
C ll and lv
u lll and lv
3 Cholce of Lhe meLhod of deconLamlnaLlon depends on all Lhe followlng excepL
A naLure of ob[ecL Lo be deconLamlnaLed
8 Cb[ecL's Lolerance Lo Lhe process of deconLamlnaLlon
C uesLroys all vegeLaLlve bacLerla lncludlng Lubercle bacllll
u Cb[ecL's mlcroblal load
38 WhaL ls Lhe meanlng of dlslnfecLlon"
A rocess by whlch organlsms are removed or desLroyed ln order Lo render an ob[ecL safe
8 lreelng of an arLlcle from some or all of lLs conLamlnaLlng mlcroorganlsms excepL spores
C klll mlcroorganlsms by causlng a desLrucLlve oxldaLlon of essenLlal cell consLlLuenLs
u rocess whlch achleves Lhe compleLe desLrucLlon or kllllng of all mlcroorganlsm lncludlng
spores
39 All Lhe followlng are Lrue regardlng cleanlng excepL
A LssenLlal sLep before successful dlslnfecLlon and sLerlllzaLlon
8 ulLable meLhod for deconLamlnaLlon of envlronmenLal surfaces
C vlslble dlrL or organlc maLLer are mechanlcally removed
u 8lnslng laundry or eaLlng uLensll ln waLer aL 080C for few mlnuLes
40 Choose Lhe false sLaLemenL regardlng LyndalllzaLlon process
A Lxposure Lo bolllng waLer for 20 mlnuLes achleves hlgh level dlslnfecLlon
8 pores LhaL survlve Lhe lnlLlal heaLlng wlll germlnaLe ln Lhe medlum ln room LemperaLure
C useful meLhod of sLerlllzaLlon of laboraLory medla conLalnlng sugar or gelaLln
u vegeLaLlve forms wlll be kllled on Lhe second day when medlum ls reheaLed
41 All Lhe followlng are Lrue regardlng sLerlllzaLlon by molsL heaL excepL
A 8equlres LemperaLures above LhaL of bolllng waLer
8 8alslng Lhe pressure Lo double aLmosphere lncreases Lhe LemperaLure Lo 130C
C AuLoclave ls used ln all operaLlng LheaLres for sLerlllzaLlon of hlgh rlsk (crlLlcal lLems)
u kllls mlcroorganlsms by coagulaLlng and denaLurlng Lhelr enzymes and sLrucLural proLelns

42 Whlch of Lhe followlng conLrlbuLed Lo Lhe decrease ln reporLed syphllls cases LhaL began ln
Lhe 1930s"
A 1he end of World War ll
8 1he beglnnlng of Lhe korean War
C use of penlclllln Lo LreaL syphllls
u uecrease ln syphllls survelllance efforLs

43 AL whlch sLage of syphllls can neurosyphllls occur"

A rlmary syphllls
8 econdary syphllls
C 1erLlary syphllls
u LaLenL syphllls of unknown duraLlon
L Any sLage of dlsease

44 Whlch of Lhe followlng ls Lrue abouL prlmary syphllls"
A A palnful chancre occurs aL Lhe slLe of lnoculaLlon
8 1he chancre ls generally palnless and resolves wlLhouL LreaLmenL
C nonLreponemal serologlc LesLs are always poslLlve
u Cenerallzed lymphadenopaLhy ls common

43 Whlch of Lhe followlng ls a slgn of secondary syphllls"

A Alopecla
8 Chancre aL Lhe slLe of lnoculaLlon
C CondylomaLa laLa
u almar/planLar rash
L apulosquamous rash

46 MucocuLaneous leslons are mosL commonly seen durlng whlch sLage of syphllls"
A rlmary
8 econdary
C LaLenL
u 1erLlary
4 Whlch of Lhe followlng ls Lrue regardlng LreaLmenL of a woman dlagnosed wlLh secondary
syphllls ln her 36
Lh
week of pregnancy"
A 1he recommended LreaLmenL ls eryLhromycln 300 mg four Llmes dally for 14 days
8 yphllls ls noL LransmlLLed Lo Lhe feLus so she does noL have Lo worry abouL her baby
C he wlll geL mulLlple shoLs and Lhls wlll be adequaLe LreaLmenL for boLh she and Lhe
baby
u he needs lmmedlaLe LreaLmenL wlLh penlclllln and Lhe baby wlll need LreaLmenL afLer
blrLh




48 ln pregnancy Lhe rlsk of Lransmlsslon Lo Lhe feLus ls hlghesL durlng whlch sLage(s) of syphllls"

A rlmary and secondary
8 LaLe laLenL
C Larly laLenL
u 1he rlsk ls Lhe same regardless of Lhe sLage of dlsease

49 Whlch of Lhe followlng ls Lrue regardlng Lhe progresslon of syphllls"

A 1he mosL common cllnlcal manlfesLaLlon of prlmary syphllls ls a chancre aL Lhe slLe of
lnoculaLlon
8 MucocuLaneous leslons may occur durlng secondary syphllls
C 1erLlary syphllls ls rare
u All of Lhe above are correcL

30 A paLlenL wlLh no cllnlcal slgns or sympLoms a hlsLory of a palmar rash slx monLhs ago and a
poslLlve serologlc LesL for syphllls (poslLlve nonLreponemal LesL wlLh a poslLlve conflrmaLory
Lreponemal LesL) flLs Lhe crlLerla for

A econdary syphllls
8 LaLe laLenL syphllls
C Larly laLenL syphllls
u none of Lhe above

31 1he Lransverse wrlnkllng of Lhe lnLlma ls speclflc ln

A Cumma benlgn LerLlary syphllls
8 neurosyphllls
C yphlllLlc aorLlLls
u lnfanLlle congenlLal syphllls
L LaLe congenlLal syphllls

32 hepar lobaLum" ls a characLerlsLlc of

A Cumma benlgn LerLlary syphllls
8 Cardlovascular syphllls
C Pealed llver mulLlple gummaLa (by flbrosls)
u abre Llbla
L MaceraLed skln wlLh mulLlple maculopapular rashes

33 Whlch of Lhe followlng are noL Lrue regardlng lmmunlLy Lo exLracellular bacLerlal lnfecLlons"
A 1L8 blnds Lo paLhogen assoclaLed molecular paLLern presenL ln dlfferenL organlsms
8 naLural klller cells klll lnfecLed cells and secreLe lnLerferongamma
C lgA prevenL adherence of bacLerla Lo Lhelr LargeL cells
u Cpsonlns enhance phagocyLosls


34 1he followlng lnfecLlons need lnLracellular lmmunlLy LxCL1
A 8ubella
8 1uberculosls
C LlsLerlosls
u Candlda
33 1he followlng are noL Lrue regardlng lmmunlLy Lo bacLerlal vlral and fungal lnfecLlons LxCL1
l AcLlvaLed 1helper cells lnduce local lnflammaLlon by lLs released cyLoklnes
ll AnLlbodles acL as opsonlns agalnsL bacLerlal lnfecLlons whereas complemenL componenL
acL as opsonlns agalnsL vlral lnfecLlons
lll allvary sLaphylococcl ls a Lype of commensal bacLerla whlch secreLe hydrogen peroxlde
lv Macrophages are acLlvaLed and aLLracLed by cyLoklnes released from Cu4+ cells

A lll and lll
8 lll and lv
C lllll and lv
u llll and lv
36 1he followlng are Lrue regardlng lmmunlLy Lo vlral lnfecLlons
l naLural klller cells klll vlrus lnfecLed cells before appearance of anLlbodles
ll AnLlbodles blnd Lo vlrus lnfecLed cells whlch Lhen lysed by nk cells
lll ln lnfluenza lnfecLlons lnLerferonalpha acLs by lnhlblLlng lnLracellular repllcaLlon of Lhe
vlrus
lv AggregaLlon and opsonlzaLlon of vlrus ls carrled ouL by anLlbodles

A lll and lll
8 lll and lv
C lllll and lv
u llll and lv

3 Whlch of Lhe followlng ls noL lnvolved dlrecLly ln lmmunlLy Lo lnLracellular bacLerla
A naLural klller cells
8 Macrophages
C CyLoLoxlc 1cells
u 1 helper cells





ANSWLkS
Aag kn















1) u 139 16) u 10 31) u 11611 46) 8
2) 8 139 1) u 106 32) 8 118 4) u
3) C 138 18) A 108 33) u 119 48) A
4) A 160 19) 8 109 34) A 120 49) u
3) 8 161 20) C 110 33) C 121122 30) 8
6) 8 98 21) A 11C 36) 8 124 31) C
) u 100 22) 8 10 3) C 32) C
8) 8 100 23) C 38) 8 33) 8
9) u 100 24) u 108 39) u 34) u
10) C 98 23) A 109 40) A 33) 8
11) u 106 26) C 112 41) 8 36) 8
12) 8 106 2) u 114 42) C 3) u
13) C 106 28) A 114113lecLure 43) C
14) C 106 29) 8 11 44) 8
13) 8 10 30) 8 113116lecLure 43) 8
Wahal orangorang yang berlman! 8ersabarlah kamu dan kuaLkanlah
kesabaranmu dan bersedlalah serLa berLakwalah kepada Allah supaya
kamu ber[aya"
urah All'lmran 3 200