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Question 1
Correct
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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 + antibiotics
Explanation: -
This question is part of the following fields:
- Immune System
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Question 2
Correct
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Type 2 hypersensitivity is mediated by:
Your 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.
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This question is part of the following fields:
- Immune System
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Question 3
Incorrect
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Which of the following immune responses occurs in Coeliac disease?
Your Answer: Type III 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.
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This question is part of the following fields:
- Immune System
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Question 4
Correct
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Choose the molecule that acts as the co-receptor for cells expressing antigens linked with MHC class I molecules:
Your 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.
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This question is part of the following fields:
- Immune System
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Question 5
Incorrect
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Question 6
Correct
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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.
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This question is part of the following fields:
- Immune System
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Question 7
Correct
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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.
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This question is part of the following fields:
- Immune System
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Question 8
Correct
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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: 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.
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This question is part of the following fields:
- Immune System
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Question 9
Incorrect
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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: Reassurance
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.
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This question is part of the following fields:
- Immune System
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Question 10
Correct
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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.
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This question is part of the following fields:
- Immune System
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