Immunoprophylaxis
Question 1. All of the following vaccines are given under universal program of immunization India; except:
- Rotavirus
- Influenza
- Adult JE
- Measles and Rubella
Answer. (2) (Influenza)
- Influenza is not given under national immunization program of India
Read And Learn More: Micro Biology And Immunology Multiple Choice Question And Answers
Question 2. Which of the following parameters is used to determine the sensitivity of vaccine due to heat?
- VVM
- VCM
- VMV
- VMM
Answer. (1) (VVM)
Vaccine vial monitor (VVM) is a tool to monitor the stability/potency of a vaccine and to check the efficiency of cold chain.
Question 3. Time gap between two live vaccines
- 2 weeks
- 4 weeks
- 6 weeks
- 8 weeks
Answer. (2) (4 weeks)
When two live vaccines are required to be given; they should be administered with an interval of at least 4 weeks. Exception is yellow fever vaccine which is given less than 4 weeks after MMR vaccine
Question 4. Post-exposure prophylaxis is available for which of the following(s)?
- Rabies
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Varicella
Answer. (1, 2, 3, 5) (Rabies, Hepatitis A, Hepatitis B, Varicella)
Post-exposure prophylaxis (immunoglobulins) is available for- Rabies, Hepatitis A, Hepatitis B, Varicella, CMV, Diphtheria, tetanus, botulism, rubella, and measles.
Question 5. Vaccine contraindicated in HIV:
- MMR
- Varicella
- Hepatitis A
- Hib
- DPT
Answer. (1, 2) (MMR, Varicella)
- Live attenuated vaccines such as MMR, varicella vaccines are contraindicated in immunocompromised conditions such as HIV.
Question 6. Which vaccine can be given to pregnant women?
- Hepatitis B
- Meningococcus
- Rabies
- Measles
- BCG
Answer. (1, 2, 3) (Hepatitis B, Meningococcus, Rabies)
All live vaccine such as Measles and BCG are contraindicated in pregnancy
Question 7. According to national immunisation schedule, which of the following is recommended for a child of 5-year of age?
- Pentavalent vaccine and vitamin A
- DT booster
- DT, OPV and vitamin A
- DPT booster and vitamin A
Answer. (4) (DPT booster and vitamin A)
According to national immunization schedule in India:
- DPT schedule: 1st/2nd/3rd dose at 6/10/14 weeks and two boosters at 16–24 months and 5–6 yr
- Vitamin A: 1st dose at 9 month (along with measles), 2nd dose at 16–24 months (along with DPT booster) and the 3rd to 9th dose given every 6 month till 5 yrs.
- OPV schedule: Zero dose at birth, then 1st/2nd/3rd dose at 6/10/14 weeks and booster at 16–24 months.
Question 8. Live attenuated vaccine:
- Mumps
- Hepatitis B
- Salk vaccine
- Typhoral
Answer. (4) (Typhoral)
Question 9. Anti-centromere antibodies are seen in which of the followings conditions:
- Drug-induced lupus
- SLE
- Sjögren syndrome
- Scleroderma
Answer. (4) (Scleroderma)
Scleroderma (Systemic sclerosis) is of two types:
- Diffuse scleroderma: Autoantibodies against DNA topoisomerase I (anti-Scl 70) is elevated
- Limited scleroderma: ↑ Anticentromere antibody, characterized by CREST syndrome—calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia
Question 10. Cannot be diagnosed without positive ANA:
- SLE
- Sjögren
- Drug-induced lupus
- Scleroderma
Answer. (1) (SLE)
Question 11. Rheumatoid arthritis is associated with involvement of all except
- Neutrophil
- Macrophage
- Lymphocyte
- Antibody
Answer. (1) (Neutrophil)
Rheumatoid arthritis is associated with involvement of Macrophage, Lymphocyte, and IgM Antibody
Question 12. About myasthenia gravis, true is
- Antibody to Ach receptor
- Antibody to anti- Ca receptor
- Ach is not secreted
- Blockage of nerve conduction trough myoneural junction
Answer. (1) (Antibody to Ach receptor)
Question 13. Which of the following is a immunologically privileged site?
- Seminiferous tubule
- Area postrema
- Optic nerve
- Loop of henle
Answer. (1) (Seminiferous tubule)
Seminiferous tubule, spermatozoa, lens protein, placenta, and the fetus are the immunologically privileged sit Brain is no longer considered immunologically privileged.
Question 14. Which is not an autoimmune disorder?
- Myasthenia gravis
- Sickle cell anemia
- Graves’ disease
- SLE
Answer. (2) (Sickel cell anemia)
Question 15. Autoimmunity can be caused due to all of the following except:
- The pressure of forbidden clones
- Expression of cryptic antigens
- Negative selection of T-cells in the thymus
- Inappropriate expression of the MHC proteins
- Immunodeficiency
Answer. (3) (Negative selection of T-cells in thymus)
- Negative selection of T-cell is a process by which self-reactive T-cells are killed in thymus–this is one of the mechanism of preventing development of Autoimmunity.
- The other options are the mechanisms of preventing Autoimmunity:
- Forbidden clones with self-reactivity arise as a result of failure of negative selection of autoreactive T-cell.
- Cryptic antigens are the antigenic epitopes, which are normally not exposed, gets exposed to the immune system as a result of injury or infection and leads to development of immune response.
- Inappropriate expression of MHC proteins also leads to development of self-destructive immune response.
Question 16. True about ataxia telangiectasia
- Autosomal; dominant
- Occurs in adults
- Poor coordination and telangiectasia present
- Oculomotor apraxia
Answer. (1) (Autosomal; dominant)
Question 17. A 4-year-old boy had three episodes of cervical lymphadenitis; which were incised and drainage was donLast episode was two months back. Child also has hepatic abscess which was also drained two years back. Pus culture shows Staphylococcus aureus. The nitroblue-tetrazolium (NBT) test was found to be positivMost probable diagnosis is:
- Tuberculosis
- Kostman disease
- Chronic granulomatous disease
Answer. (3) (Chronic granulomatous disease)
Question 18. Mutation associated with Wiskott-Aldrich syndrome:
- Y chromosome
- Chromosome 11p22
- Chromosome 22q11
- X chromosome
Answer. (4) (X chromosome)
Wiskott Aldrich syndrome is an X linked disease, gene encoded at Xp11.23 region.
Question 19. Viral infection associated with B cell deficiency:
- Enterovirus
- CMV
- EBV
- Herpes virus
Answer. (1) (Enterovirus)
T-cell deficiency predisposes to CMV, EBV, and varicella; whereas B-cell defects predisposes to Enterovirus encephalitis.
Question 20. True about severe combined immunodeficiency is/are:
- B & T cell deficiency
- Adenosine deaminase deficiency may occur
- Affected child can survives beyond adolescence without treatment
- Can transmit either as X-linked or autosomal recessive defect
- Person susceptible to recurrent and severe infections
Answer. (1, 2, 3, 5) (B & T cell.., Adenosine deaminase.., Can transmit.., Person susceptible..)
In Severe Combined Immunodeficiencies (SCID), both CMI are AMI are affecteIt runs as:
- X linked: Mutation in cytokine receptor
- Autosomal recessive: It occurs as: (1) Adenosine deaminase (ADA) deficiency, (2) Jak3 mutation, (3) RAG mutation, and (4) Class II MHC deficiency
- The affected infants are susceptible to severe recurrent infections by a wide array of pathogens, including Candida, Pneumocystis, cytomegalovirus, and Pseudomonas.
- Prognosis of SCID is poor. Bone marrow transplantation is the mainstay of treatment.
Question 21. Chronic granulomatous disorder is due to defect in:
- B-cell
- NADPH oxidase
- IgA
- T-cell
Answer. (2) (NADPH oxidase)
Chronic granulomatous disease:
- Due to defect in phagocytosis (results from absence of NADPH oxidase)
- ↑ Recurrent catalase +ve pyogenic infection (catalase –ve organisms are handled normally)
- Screening test used- Nitroblue tetrazolium (NBT) reduction test is negative.
Question 22. Purine Nucleoside phosphorylase deficiency:
- Humoral immunity deficiency
- Acquired immunity deficiency
- SCIDs
- Cell-mediated immunity deficiency
Answer. (4) (Cell mediated immunity deficiency)
- Purine Nucleoside phosphorylase deficiency is an autosomal recessive inherited trait, leads to low CMI & ↑ Recurrent infection (Candidiasis), hypoplastic anemia & ↓ uric acid.
Question 23. Decreased IgM, bleeding tendency with eczema is seen in:
- Wiskott-Aldrich syndrome
- Chronic granulomatous disease
- Job’s syndrome
- Chediak Higashi syndrome
Answer. (1) (Wiskott-Aldrich syndrome)
Wiskott-Aldrich syndrome (Refer Chapter review for detail)
Question 24. In a 5-year-old boy who has history of pyogenic infections by bacteria with polysaccharide-rich capsules, which of the following investigations should be done?
- IgA deficiency
- IgG1 deficiency
- IgG2 deficiency
- IgA and IgG2 deficiency
Answer. (3) (IgG2 deficiency)
- IgG2 subclass is the predominant antibody raised against the polysaccharide capsular antigens and deficiency of IgG2 subclass is commonly associated with recurrent pyogenic infection due to bacteria with polysaccharide capsule like Str.pneumoniae or H.influenzae.
According to the memory recall of some other students….
- The question asked as- ‘Boy with history of recurrent sinopulmonary infections by bacteria with polysaccharide-rich capsules’.
- IgA deficiency: Due to history of recurrent sinopulmonary infections
- IgA is the major immunoglobulin in mucosal secretions and weakened mucosal defenses predispose patients to recurrent sinopulmonary infections and diarrhea…
- IgG2 deficiency: Due to infections by bacteria with polysaccharide-rich capsules.
Question 25. Adenosine deaminase deficiency is seen in the following:
- Common variable immunodeficiency
- Severe combined immunodeficiency
- Chronic granulomatous disease
- Nezel of syndrome
Answer. (2) (Severe combined immunodeficiency)
- Severe combined immunodeficiency results from various mechanisms: MC mechanism is X-linked (mutation in IL7 receptor).
- Other mechanism include Adenosine deaminase (ADA) deficiency.
Question 26. The commonest primary immunodeficiency is:
- Common variable immunodeficiency
- Isolated IgA immunodeficiency
- Wiskott–Aldrich syndrome
- AIDS
Answer. (2) (Isolated IgA immunodeficiency)
- Among immunodeficiency diseases, primary immunodeficiency is relatively uncommon,when compared to secondary immunodeficiency (common).
- The most common is isolated IgA deficiency, occurs in approximately 1 in 600 individuals (in Europe and North America) and it is reported in about 0.2% of normal populations.
- Next most common disorder: Common variable immunodeficiency, characterized by pan hypogammaglobulinemia.
- Both of these immunodeficiency states often become clinically evident in young adults.
- The more severe forms of primary immunodeficiency are relatively rare, have their onset early in life, and frequently result in death during childhood.
Question 27. Which is found in DiGeorge’s syndrome?
- Tetany
- Eczema
- Mucocutaneous Candidiasis
- Absent B-and T-cells
- Total absence of T-cells
Answer. (1, 3) (Tetany, Mucocutaneous Candidiasis)
Question 28. Disorders of phagocytosis are all except:
- Job’s syndrome
- Chediak-Hegashi syndrome
- Myeloperoxidase deficiency
- Wiskott-Aldrich syndrome
- Tuftsin deficiency
Answer. (4) (Wiskott-Aldrich Syndrome)
Hyperacute rejection reactions typically occur within the first 24 hours after transplantation,acute rejection reactions usually begin in the first few weeks after transplantation, and chronic rejection reactions can occur from months to years after transplantation
Question 29. Hyperacute graft rejection is seen within
- 24 hours
- 1 week
- 1 month
- 1 year
Answer. (1) (24 hours)
Question 30. A woman with infertility receives an ovary transplant from her sister who is an identical twin. What type of graft is?
- Xenograft
- Autograft
- Allograft
- Isograft
Answer. (4) (Isograft)
Question 31. Hyperacute graft rejection is seen in:
- Bone marrow
- Kidney
- Liver
- Heart
Answer. (2) (Kidney)
- Hyperacute graft rejection is seen in kidney and skin grafting and is preformed antibody-mediated (Type III Hypersensitivity reaction)
Question 32. Allograft rejection is an example of:
- GVHD
- Delayed (cell-mediated) hypersensitivity
- Immediate hypersensitivity
- Acute rejection
- Immunohematology
Answer. (2) (Delayed…)
Question 33. A trauma patient presents at emergency department. There is no time for cross-matching. FFP of which group can be transfused safely:
- O Rh D +
- O Rh D –
- AB Rh D +
- AB Rh D –
Answer. (2) (O Rh D –)
- Universal donor: Individuals with ‘O’ Rh D negative blood group are called as universal donors because they do not possess either A or B antigen or Rh-antigen; hence, they are generally safe.
The anti-A and anti-B antibodies in the transfused O blood group are diluted in recipient’s serum, do not ordinarily cause any damage to the red cells of the A or B blood group recipients - Universal recipients: Individuals with AB Rh D positive blood group do not have both A and B antibodies or Rh D antibodies in serum; therefore, they can receive any other blood group. Hence, they are called as universal recipients.
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