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  • Question 1 - A 25-year-old female presented following an insect bite she complained of itching at...

    Incorrect

    • A 25-year-old female presented following an insect bite she complained of itching at the site of bite. What is the most appropriate management can be done at this stage?

      Your Answer: Doxycycline oral

      Correct Answer: Oral antihistamine

      Explanation:

      Itching is due to release of histamine locally as a reaction to insect bites. Oral antihistamines are adequate as she doesn’t have other systemic features of anaphylaxis.

    • This question is part of the following fields:

      • Immune System
      96.5
      Seconds

  • Question 2 - Choose the molecule that acts as the co-receptor for cells expressing antigens linked...

    Incorrect

    • Choose the molecule that acts as the co-receptor for cells expressing antigens linked with MHC class I molecules:

      Your Answer: CD4

      Correct Answer: CD8

      Explanation:

      CD8+ T cells recognize antigens in the form of short peptide fragments bound to major histocompatibility complex class I (MHCI) molecules on the target cell surface.1 Specific engagement of peptide-MHCI (pMHCI) complexes via the clonotypically expressed ?β T-cell receptor (TCR) triggers a range of effector functions that play a critical role in protective immunity against intracellular infections and various malignancies.

    • This question is part of the following fields:

      • Immune System
      98.7
      Seconds

  • Question 3 - A 52-year-old gentleman known with rheumatoid arthritis presented with a 5 day history...

    Correct

    • A 52-year-old gentleman known with rheumatoid arthritis presented with a 5 day history of red, painful swollen knee joint. He was afebrile and the joint was warm on touch. Hamstring muscles were spastic. Which of the following tests should be done next?

      Your Answer: Joint aspiration for cytology and culture and sensitivity

      Explanation:

      Rheumatoid arthritis can affect any joint of the body. Aspirate will reveal increased TLC, and it will be sterile.

    • This question is part of the following fields:

      • Immune System
      89.2
      Seconds

  • Question 4 - What do T-helper cells of the Th2 subset typically secrete? ...

    Incorrect

    • What do T-helper cells of the Th2 subset typically secrete?

      Your Answer: IL-1, IL-6, TNF-alpha

      Correct Answer: IL-4, IL-5, IL-6, IL-10, IL-13

      Explanation:

    • This question is part of the following fields:

      • Immune System
      154.6
      Seconds

  • Question 5 - A 62 year-old male presents with exertional chest pain and is found to...

    Correct

    • A 62 year-old male presents with exertional chest pain and is found to have extensive coronary artery disease on angiogram. Which of the following cell types is most implicated in the development of coronary artery plaques?

      Your Answer: Macrophages

      Explanation:

      An atheroma is an accumulation of degenerative material in the tunica intima (inner layer) of artery walls. The material consists of (mostly) macrophage cells, or debris, containing lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue.

    • This question is part of the following fields:

      • Immune System
      30.2
      Seconds

  • Question 6 - A 20-year-old female has been admitted with an acute infection. She gives a...

    Correct

    • A 20-year-old female has been admitted with an acute infection. She gives a history suggestive of hypersensitivity to amoxicillin. After consultation with the allergy specialist, she has now been diagnosed with an IgE mediated penicillin allergy. Which of the following drugs should be avoided in this patient?

      Your Answer: Cefalexin

      Explanation:

      Cefalexin should be avoided in this patient.
      This patient is known to have a severe penicillin allergy. None of the above antibiotics are penicillin based. However, 0.5 – 6.5% of patients who are proven to have an IgE mediated penicillin allergy will also be allergic to cephalosporins, including cefalexin.

      Penicillin, cephalosporins, and carbapenems are all members of the beta-lactam group of antibiotics and share a common beta-lactam ring. There is, therefore, a small risk of allergy cross-over between all these antibiotics. The rates of allergy cross-over are lower with second and third-generation cephalosporins than first-generation cephalosporins such as cefalexin.

      It is important to question the patient carefully to ascertain what symptoms they had on exposure to penicillin. Symptoms such as an urticarial rash or itching make it more likely that they have an IgE mediated allergy.

    • This question is part of the following fields:

      • Immune System
      50.3
      Seconds

  • Question 7 - A 28-year-old female presented with complaints of joint pains, myalgia, haematuria and a...

    Correct

    • A 28-year-old female presented with complaints of joint pains, myalgia, haematuria and a facial rash which exacerbates on exposure to sunlight. RFTs show raised urea and creatinine, and there were red cell casts on urine microscopy. The investigation of choice in this case would be?

      Your Answer: Auto antibodies

      Explanation:

      Considering the history and presenting complaints, this patient is most likely suffering from systemic lupus erythematosus, which will be confirmed by testing for auto antibodies like ANA, anti ds DNA, anti histone antibodies etc.

    • This question is part of the following fields:

      • Immune System
      67.9
      Seconds

  • Question 8 - A 6-year-old boy arrives at the clinic seven hours after having injured his...

    Incorrect

    • A 6-year-old boy arrives at the clinic seven hours after having injured his hand with a metal spike. Examination reveals a puncture wound 0.5 cm deep. His immunization schedule is uptodate. How will you manage this patient?

      Your Answer: Tetanus Ig + tetanus vaccine + antibiotics

      Correct Answer: Tetanus Ig + antibiotics

      Explanation:

    • This question is part of the following fields:

      • Immune System
      59.6
      Seconds

  • Question 9 - Which one of the following statements regarding interleukin 1 (IL-1) is true? ...

    Correct

    • Which one of the following statements regarding interleukin 1 (IL-1) is true?

      Your Answer: It is released mainly by macrophages/monocytes

      Explanation:

      Interleukin 1 alpha and interleukin 1 beta (IL1 alpha and IL1 beta) are cytokines that participate in the regulation of immune responses, inflammatory reactions, and hematopoiesis. It is secreted mainly by macrophages and monocytes and acts as a costimulator of T cell and B cell proliferation.

    • This question is part of the following fields:

      • Immune System
      21.6
      Seconds

  • Question 10 - Which of the following immune responses occurs in Coeliac disease? ...

    Incorrect

    • Which of the following immune responses occurs in Coeliac disease?

      Your Answer: Type II hypersensitivity

      Correct Answer: Type IV hypersensitivity

      Explanation:

      Celiac disease is classified as a Type IV hypersensitivity mediated by T-cell response. Negatively charged gliadin has been shown to induce interleukin 15 in the enteric epithelial cells, stimulating the proliferation of the natural killer cells and intraepithelial lymphocytes to express NK-G2D, a marker for natural killer T lymphocytes.

    • This question is part of the following fields:

      • Immune System
      86.2
      Seconds

  • Question 11 - The immunoglobulin found in the highest concentration in humans is ...

    Correct

    • The immunoglobulin found in the highest concentration in humans is

      Your Answer: IgG

      Explanation:

      Representing approximately 75% of serum antibodies in humans, IgG is the most common type of antibody found in the circulation. IgG molecules are created and released by plasma B cells.

    • This question is part of the following fields:

      • Immune System
      15.7
      Seconds

  • Question 12 - A 1-day-old baby started having pallor and jaundice. The mother's first child did...

    Correct

    • A 1-day-old baby started having pallor and jaundice. The mother's first child did not have jaundice at birth. On clinical investigations, direct Coombs test is positive. Mother's blood group is A negative. Baby's blood group is O positive. What is the most probable cause of the condition of this new-born?

      Your Answer: Rhesus incompatibility

      Explanation:

      Jaundice in a new-born on the day of delivery is most likely due to Rh incompatibility. This occurs when the mother is Rh-negative and the baby is Rh-positive. Antibodies in the mother against the Rh factor in the baby will destroy the red blood cells in the baby, increasing the bilirubin in the blood. Breast milk jaundice and Galactosemia do not occur immediately after birth, and congenital rubella syndrome and formula feeding does not cause jaundice in babies.

    • This question is part of the following fields:

      • Immune System
      78.7
      Seconds

  • Question 13 - Type 2 hypersensitivity is mediated by: ...

    Incorrect

    • Type 2 hypersensitivity is mediated by:

      Your Answer: IgG only

      Correct Answer: IgG, IgM & complement

      Explanation:

      In type II hypersensitivity the antibodies, IgG and IgM bind to antigens to form complexes that activate the classical pathway of complement to eliminate cells presenting foreign antigens.

    • This question is part of the following fields:

      • Immune System
      30.7
      Seconds

  • Question 14 - A 45-year-old woman with a history of hypothyroidism, presents with ptosis and muscle...

    Correct

    • A 45-year-old woman with a history of hypothyroidism, presents with ptosis and muscle weakness. She's noticed that her muscle weakness becomes worse towards the end of the day. Clinical examination reveals fatigable ptosis and proximal limb weakness. Myasthenia gravis is suspected. Which receptor is implicated in the pathophysiology of this condition?

      Your Answer: Nicotinic acetylcholine receptors

      Explanation:

      Myasthenia gravis (MG) is an organ-specific autoimmune disease caused by an antibody-mediated assault on the muscle nicotinic acetylcholine receptor (AChR) at the neuromuscular junction. Binding of antibodies to the AChR leads to loss of functional AChRs and impairs the neuromuscular signal transmission, resulting in muscular weakness.

    • This question is part of the following fields:

      • Immune System
      237
      Seconds

  • Question 15 - A 13-year-old male, who is otherwise healthy, has presented with recurrent episodes of...

    Correct

    • A 13-year-old male, who is otherwise healthy, has presented with recurrent episodes of swelling in his face and tongue. He also complains of abdominal pain. His father has had similar episodes. Choose the most likely diagnosis for this patient.

      Your Answer: C1 esterase deficiency

      Explanation:

      C1 esterase deficiency is most often associated with swelling of the peripheries and laryngeal oedema. Severe pain in the abdomen is also consistent with this diagnosis. It is also an autosomal dominant condition.

    • This question is part of the following fields:

      • Immune System
      20.2
      Seconds

  • Question 16 - A 55-year-old lady, known with rheumatoid arthritis, complains of increasing numbness and tingling...

    Incorrect

    • A 55-year-old lady, known with rheumatoid arthritis, complains of increasing numbness and tingling in her feet and hands. She has recently developed an ulcer on her left heel, after having burnt her foot in a hot bath. A number of depigmented areas are readily seen over her upper limbs.

      She is currently taking low-dose prednisolone (7.5 mg daily), alendronic acid, lansoprazole, paracetamol, indomethacin, methotrexate and rituximab.

      Her blood tests demonstrate:
      Haemoglobin 9.9 g/l
      MCV 102 fl
      Platelets 410 x 109/l
      White blood cells 12.3 x 109/l
      Vitamin B12 97 pg/ml
      Folate 12.3ng/ml
      Random blood glucose 9.9 mmol/l
      Thyroid-stimulating hormone 4.7 mU/ml
      Thyroxine 12.8 pmol/l

      Which autoantibody would be most diagnostic for the underlying disease?

      Your Answer: Antigastric parietal cell (PCA)

      Correct Answer: Anti-intrinsic factor (IF)

      Explanation:

      This clinical scenario describes pernicious anaemia. Anti-intrinsic factor (IF) antibodies are most specific for pernicious anaemia. Antigastric parietal cell antibodies have a higher sensitivity but are less specific for pernicious anaemia. The other antibodies listed are not related to pernicious anaemia. Anti-TTG is seen with Celiac’s disease, anti-TPO is seen with thyroid disease, GAD is seen with type I diabetes, but this does not explain her anaemia.

    • This question is part of the following fields:

      • Immune System
      1699.4
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Immune System (9/16) 56%
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