浙江大学医学免疫学免疫习题1.doc

一、 选择题(选择一个最佳答案填写在括号内,每题1 分,共30 分)( )1免疫的正确概念是A机体对病原微生物的防御能力 B机体抗传染的过程C机体识别和排除抗原性异物的功能 D机体清除杀灭自体突变细胞的功能E机体清除自身衰老、死亡的组织细胞的功能( )2A族溶血性链球菌感染导致的风湿性心脏病的原因是A隐蔽性抗原的释放 BTh细胞调节异常 C自身抗原被修饰D决定簇扩展 E异嗜性抗原的作用( )3IgE 抗体主要引起A速发型超敏反应 B迟发型超敏反应 C细胞毒型超敏反应D血管炎型超敏反应 E自身免疫性疾病( )4体外支持 T 细胞生长的细胞因子是AIL-1 BIL-2 CIL-3 DIL-4 EIL-5( )5医学免疫学研究的是A病原微生物的感染和机体防御能力 B抗原抗体间的相互作用关系C人类免疫现象的原理和应用 D动物对抗原刺激产生的免疫应答E细胞突变和免疫监视功能( )6. BCR 的主要抗体类型是A.IgG 和IgM B.IgA 和IgD C.IgD 和IgE D.IgM 和IgD E.IgE 和IgD( )7免疫监视功能是指机体A抵抗病原微生物感染的功能 B杀伤、清除自身突变细胞的功能C识别和排除异物的功能 D清除自身衰老、死亡细胞的功能E防止寄生虫感染的过程( )8粘附分子ICAM-1的配体是AVCAM-1 BLFA-1 CLFA-2 DLFA-3 EVLA-4( )9. 中和病毒，中和毒素的抗体主要是A.IgG B.IgA C.IgM D.IgD E.IgE( )10引起器官移植排斥反应的抗原是A. 同种异型抗原 B.异种抗原 C.自身抗原 D.异嗜性抗原 E隐蔽抗原( )11. 有C1q识别位点的抗体是A.IgM IgG4 B.IgG13IgA C.IgM D.IgM IgG13 E.IgG13 IgE( )12. 完全抗原具有A.异物性和特异性 B.免疫原性和抗原性 C.抗原性和异物性D.理化复杂性和特异性 E.异物性和免疫反应性( )13能介导ADCC 的细胞应包括A. CTL 和NK 细胞B. 巨噬细胞、中性粒细胞和NK 细胞C. 中性粒细胞和 B 细胞D. Th 细胞、CTL 和NK 细胞E. CTL、嗜酸性粒细胞和肥大细胞( )14. 关于MHC类分子描述错误的是A.抑制NK 细胞的杀伤活性 B.链和2m 为MHC-B、C 和A 基因位点编码C.主要提呈内源性抗原 D.与CD8 分子结合 E.分布于所有有核细胞( )15.不属于自身免疫耐受建立机制的是A.B 细胞在骨髓发育成熟中的阴性选择 B.克隆无变应性 C.克隆忽视D.T 细胞在胸腺发育成熟中的阴性选择 E.免疫抑制( )16.IL-2 的主要产生细胞是A.Th1 细胞 B.Th2 细胞 C.CD8 T 细胞 D.NKT 细胞 E.细胞( )17.下列属于B7 分子的是A.CD40 B.CD80 C.CD152 D.CD28 E.CD40L( )18.免疫应答时，细胞与细胞之间不受MHC 限制的是A.Th1 细胞与APC B.Th2 细胞与B 细胞 C.CTL 识别靶细胞抗原D.NK 细胞杀伤靶细胞 E.CTL 细胞杀伤靶细胞( )19. 反复发作可导致补体含量相对降低的疾病是A.系统性红斑狼疮 B.甲状腺机能亢进 C.糖尿病 D.白血病 E.过敏性休克( )20.下列不属于IgG 特性的是A.含量最大 B.亲和力高 C. 半衰期长 D.ABO 血型抗体 E. 抗Rh 血型抗体( )21.胞内寄生菌感染是属于A迟发型超敏反应 B速发型超敏反应 C细胞毒型超敏反应D血管炎型超敏反应 E自身免疫性疾病( )22. 补体C3 转化酶是A.C4b2a B.C3bBb C.C2bBb D.C4b5b E. C3b4b( )23.下列疾病属于免疫复合物型超敏反应的是A. 肺结核 B. 血清病 C.花粉引起的哮喘D. 甲状腺机能亢进 E. 过敏性休克( )24. 保护新生儿免受感染的抗体主要是A.IgG B.IgA C.IgD D.IgM E.IgE( )25不属于诱导免疫耐受的因素是A.小分子可溶性抗原 B. 颗粒性抗原 C.超大剂量抗原D.抗原通过消化道进入 E. 极小剂量抗原( )26接触性皮炎为A.型超敏反应 B. 型超敏反应 C. 型超敏反应D. 型超敏反应 E.自身免疫病( )27.引起机体发烧的细胞因子主要是A.IL-2 B.IFN C.IL-1 D.TNF E.TGF( )28.CD4 与 MHC类分子结合位点是A.1 B.2 C.1 D.2 E.3( )29.不参与迟发型超敏反应的细胞因子是A.IL-2 B.IL-4 C.GM-CSF D.IFN- E.TNF-( )30.与速发型超敏反应无关的生物学活性物质为A. 白三烯 B. 血小板活化因子 C. 干扰素 D. 前列腺素D2 E. 组胺二. 填空题（每空0.5 分，共10 分）1.补体可以通过 1 、 2 和 3 等途径激活。2.CTL 杀伤靶细胞的机制应包括 4 、 5 和 6 。3.FcR 可分为 7 、 8 、 9 、 10 和 11 等。4.免疫细胞有 12 、 13 、 14 、 15 、 16 、 17 、 18 、 19 和 20 等。三. 名词解释(每题2.5 分,共20 分)1.表位 2.mIg 3.抗原性 4.ADCC 5.MHC 6 抗体 7补体 8.超敏反应四简答题(每题4 分，共8 分)1. 简述初次免疫应答的特点。2. 简述Fc 段的主要功能。五、论述题(每题6 分，共12 分)1. 试述细胞毒型超敏反应的发生机制。2. 试述T 细胞主要分化抗原及作用。六. 分析题(共20 分)1. 从一个正常个体外周血中分离出NK 细胞。然后，与同位素标记的靶细胞（一种肿瘤细胞）混合，检测记录靶细胞裂解情况，以反应NK 细胞的杀伤功能。检测结果如下表：NK 细胞杀伤靶细胞实验结果处理方案 细胞裂解（）不加NK 细胞 4加入NK 细胞 12NK 细胞抗靶细胞抗体 67加入纯化的穿孔素 95请问：（1）为什么NK 细胞能对靶细胞显示部分杀伤功能？加入抗靶细胞抗体可以使NK细胞的细胞毒作用增强的原因是什么（5 分）？（2） 请解释加入纯化穿孔素后的检测结果（3 分）。2. 请对表中的试验结果进行分析，指出2 个T 细胞克隆中哪一个是CD4T 细胞，哪一个是CD8T 细胞，并说明为什么（12 分）？流感病毒刺激T 细胞克隆增殖的试验结果T 抗原 对APC 处理方式 细胞增殖反应克隆1 克隆2无 活流感病毒 灭活流感病毒 活流感病毒 依米丁 活流感病毒 氯喹 注：“”表示未处理或增殖反应阴性；“”表示增殖反应阳性。 克隆1 和克隆2 是指从一只感染流感病毒的小鼠获得的2 个T 细胞克隆，其中一个是MHCI 类限制性，另一个是MHCII 类限制性。 APC 是取自于与上述T 细胞克隆基因型小鼠的巨噬细胞。 表中的下2 行是指巨噬细胞在感染流感病毒前，先用依米丁（emetine）或氯喹处理。依米丁是一种蛋白合成抑制剂，氯喹则抑制溶酶体与吞噬体的融合。医学免疫学试题A 参考答案供89 期临床、法医、影像和预防等专业用 2005 年5 月一、选择题(选择一个最佳答案,每题1 分,共30 分)1.C 2.E 3.A 4.B 5.C 6.D 7.B 8.B 9.A 10.A 11.D 12.B 13.B 14.B 15.E 16.A17.B 18.D 19.A 20.D 21.A 22.B 23.B 24.A 25.B 26.D 27.C 28.D 29.B 30.C二. 填空题（每空0.5 分，共10 分）1.补体可以通过 1 经典（C1 或传统） 、 2 替代（C3 或旁路）和 3 MBL 等途径激活。2.CTL 杀伤靶细胞的机制应包括 4 FasL 诱导靶细胞凋亡 、 5 细胞毒性颗粒形成穿孔素溶解靶细胞 和 6 颗粒酶诱导靶细胞凋亡 。3.FCR 可分为 7 FcR、 8 FcR、 9 FcR、 10 FcR 和 11 FcR 等。4.免疫细胞主要有12 T 细胞、13 B 细胞 、14 NK 细胞、15 巨噬细胞、16 树突状细胞、17 中性粒细胞 、18 嗜碱性粒细胞、19 嗜酸性粒细胞和 20 肥大细胞等。三、名词解释(每题2.5 分,共20 分)1.表位：抗原存在（表面为B 和CD8T 细胞表位或内部为CD4T 细胞表位）可供T 和B 细胞识别的部分结构。2.mIg：为B 细胞膜上的抗原受体BCR，亦称膜抗体。3.抗原性：是指免疫产物（抗体和效应性T 细胞）与相应抗原发生特异性结合的性质。4.ADCC：抗体依赖细胞介导的细胞毒作用。IgG 或IgA 与靶细胞结合后其Fc 段和携带Fc受体的效应细胞（NK cells 、M和PMN）或Fc受体的效应细胞（PMN）结合，释放穿孔素或颗粒酶导致靶细胞溶解或凋亡。5.MHC：为编码主要组织相容性抗原MHC类分子和MHC类分子的基因复合体。6.抗体：抗原刺激B 细胞分化为浆细胞，由浆细胞产生的与相应抗原发生特异性结合的球蛋白。7.补体：存在于脊椎动物血清和体液中，激活后具有酯酶活性的一组不耐热球蛋白。8.超敏反应：由免疫应答引起的生理功能障碍和免疫病理性损伤。四简答题(每题4 分，共8 分)1.简述初次免疫应答的特点。（1）潜伏期长；（2）产生的抗体以IgM 为主；（3）抗体亲和力低；（4）免疫力维持时间短。（每项1 分）。2. 简述FC 段的主要功能。（1）可激活补体（IgM 和IgG 的Fc 段）（2）通过胎盘（IgG 的Fc 段）（3）通过Fc受体和Fc受体介导ADCC 作用；（4）通过Fc受体和Fc受体促进吞噬作用（调理作用）。五、论述题(每题6 分，共12 分)1.试述细胞毒型超敏反应的发生机制（每项1.5 分）。（1）抗体IgM 和IgG 介导的补体激活溶解靶细胞；（2）主要由补体片段和抗体通过M 和PMN 的相应受体介导的免疫调理作用；（3）由结合靶细胞的抗体介导NK 细胞、M 和PMN 的ADCC 作用；（4）刺激性抗体IgG4（长效甲状腺素）作用于促甲状腺素受体，导致的甲状腺功能亢进。2.试述T 细胞主要分化抗原及作用（每项1 分）。CD2，为粘附分子，与LFA-2 结合，CD3，抗原结合信号转导，并代表其总数；CD4，作为Th 细胞亚群的标志，并与MHC类分子结合；CD8，作为Tc1（CTL）和Tc2（答Ts 细胞也算对）亚群的标志，并与MHC类分子结合；CD28，为协同刺激分子的受体，接受启动免疫应答的第二信号；CD40L，其受体为CD40，启动B 细胞的活化信号。附加说明：若答CD152；CD95，CD95L 等每项也可给0.5 分。六. 分析题(共20 分)1NK 细胞杀伤靶细胞实验结果（1）为什么NK 细胞能对靶细胞显示部分杀伤功能？加入抗靶细胞抗体可以使NK 细胞的细胞毒作用增强的原因是什么（5 分）？NK 细胞可非特异性直接杀伤丢失MHC分子的靶细胞。加入抗靶细胞抗体后，抗体与靶细胞结合，通过与NK 细胞表面的FcR 结合，即ADCC 效应增强NK 细胞对靶细胞的杀伤活性（5分）。（2） 请解释加入纯化穿孔素后的检测结果（3 分）。纯化的穿孔素本身即可有效地裂解靶细胞（3 分）。2. 请对表中的试验结果进行分析，指出2 个T 细胞克隆中哪一个是CD4T 细胞，哪一个是CD8T 细胞，并说明为什么（12 分）？克隆1 是CD8+T 细胞，克隆2 是CD4+T 细胞。因为，活流感病毒感染APC,病毒多肽在胞浆内合成。所以病毒蛋白抗原可通过MHCI 类（内源性）途径和MHCII(外原性)途径被提呈。灭活病毒被APC 摄入,无病毒蛋白在胞浆内合成，因此，病毒抗原只能通过MHCII 类途径提呈。依米丁阻断蛋白合成，无病毒新蛋白合成，只能通过MHCII 类途径提呈抗原肽。氯喹阻止溶酶体与吞噬体融合，只能经MHCI 类途径提呈抗原肽。_. Concepts ( 2.5 marks / concept, totally 20 marks ) 1. Epitope 2. Superantigen 3. Positive selection 4. Idiotype 5. APC 6. Hypersensitivity 7.Fab 8. McAb . Fill each of the blank spaces with suitable words. (0.5 mark/blank space, totally10 marks) 1. Macrophage-derived cytokines include , , , and . 2. Cells with the capacity to induce cytotoxicity of the target cell are , and . 3. Complement can be activated directly by microbes through pathway and pathway at the early stage of infection. MASP1 and MASP2 are involved in the pathway. D factor is involved in the pathway. 4. FcR is usually found on the surface of , , and cells 5Cytokines like and induce Th1 and inhibit Th2 responses, while and induce Th2 and inhibit Th1 responses. . For each of the following questions, choose the ONE BEST answer or completion. (0.5 mark / question, totally 20 marks) 1. Phagocytosis A. Is carried by cells of the adaptive immune system B. Is restricted to macrophages C. Is important in bacterial infections D. Is a process that dose not involve energy E. Results in division of the cell 2. Molecules directly involved in NK cell mediated killing include A. Muramyl dipeptide B. Granzyme 1 C. Complement D. IFN-gamma E. Superoxide 3. Dendritic cells are characterized by A. The presence of TCR B. Expression of CD3 C. Expression of IgM molecules D. Their ability to release histamine E. Their interface between the innate and adaptive immune systems 4. C3b A. Is chemotactic B. Is an anaphylatoxin C. Opsonizes bacteria D. Directly injures bacteria E. Is the inactive form of C3 5. B cell are distinguished from T cells by the presence of A. CD4 B. Surface Ig C. CD8 D. CD3 E. Class I MHC antigen 6. Specific antibodies are readily detectable in serum following primary contact with antigen after: A. 10 min B. 1 h C. 57 days D. 35 weeks E. Only following a second contact with antigen 7. Protection against microorganisms inside cells is provided by: A. T-cells B. Antibody C. C3b D. C1q E. The membrane attack complex 8. Activation of the alternative pathway involves A. C1q B. C1s C. C2 D. C3 E. C4 9. The infection in the uterus can be diagnosed based on the elevated level of antigen specific _ . A. IgG B. IgM C. IgA D. IgD E. IgE 10. Viral replication within cells is inhibited directly by A. IFN- B.TNF- C. IL-1 D. IL-4 E. IL -13 11. Which of the following gene clusters do not contribute to antigen binding A. VL B. CL C. VH D. D E. J 12. T cell antigen receptor A. Recognizes conformational epitopes on the native antigen B. Has Ig light chains C. Is made up of a heavy chain and beta-2 microglobulin 2 D. Are associated with Igand Igto form a complex E. Recognize epitopes on linear peptides associated with MHC molecules 13. The class I MHC processing pathway primarily A. Processes antigens that are present in the cytosol. B. Processes antigen from the extracellular environment C. Generates peptides, complexes them with class I MHC molecules for presentation to helper T cells D. Generates peptides, complexes them with class I MHC molecules for presentation to NK cells E. Is involved in the process of the antibody response 14. Cytokines responsible for immunosuppression include A. IL-1 B. IL-2 C. IFN- D. TGF- E. TNF- 15. _ express CD3 and CD4 molecules A. Ts and Tc cells B. Th1 and Th2 cells C. NK and B cells D. TH1 and Tc cells E. All T cells 16. Cell with specific killing effects is A. LAK B. NK C. Neutrophils D. CTL E. M 17. CD8+ T cells A. Can be classified into Th1 and Th2 subgroups based on biological functions B. Do not produce IFN C. Can recognize and kill virus infected cells D. Can bind free virus E. Do not require direct cell to cell contact with their targets for killing 18. B cell dont express A. CD2 B. MHC-molecule C. MHC-molecule D. CR2 E. LFA-3 19. Factors may influence the induction of an immune response include A. The nature of an antigen B. The route of administration C. The dose of antigen D. Maturity of the immune system E. All of the above 20. A given Ig isotype is A. A heavy chain variant encoded by allelic genes. B. A light chain constant region encoded by allelic genes. 3 C. Present in all normal individuals. D. A collection of hypervariable region epitopes recognized by an anti-idiotype. E. Monoclonal. 21. IgG: A. Appears early in the immune response. B. Kills bacteria directly. C. Is important in mucosal immunity. D. Usually exists as a pentamer. E .Opsonizes bacteria. 22. IgA in seromucus secretions: A. Has no J-chain. B. Has no secretory piece. C. Is dimeric. D. Cannot bind to virus. E. Activates the classical complement pathway. 23. Which CD molecule can bind with HIV specifically? A.CD2 B.CD4 C.CD8 D.CD21 E.CD28 24. The secondary, but not the primary, immune response is based on A. Memory B. The bonus effect of multivalency C. Complement activation D. Mast cell degranulation E. Clonal selection 25. Which of the following is true? A. CD4 MHC- B. CD8 MHC- C. CTLA-4 B7 D. CD40 CD58 E. CD2 ICAM-1 26. The cytokine which is most involved in the class switch to IgE production is A. IL-1 B. IL-2 C. IL-3 D. IL-4 E. IL-5 27. The C3 convertase in classical pathway of complement activation is A. C3bBb B.C4b2b C.C4a2b D.C4b2b3b E.C3bnBb 28. The molecules mediating signal transduction following antigen binding to cell surface immunoglobulin on a B-cell are called: A. Ig Fc B. Ig-alpha and Ig-beta C. MHC D. CD4 4 E. CD3 29. A severe depression of CD4+ T cell subset in man is likely to result in A. Severe depression of humoral immune response B. Lack of development of skin delayed hypersensitivity reactions C. Both A and B D. Neither A nor B E. Lack of complement 30. Cytokines always act A. By binding to specific receptors. B. In an autocrine fashion. C. At long range. D. Antagonistically with other cytokines. E. Synergistically with other cytokines. 31. T cell-derived cytokines A. Are antigen-specific products of T cell activation B. Are stored in the resting T cell and released on activation C. Are MHC-restricted in their effects D. Influence the class of antibodies produced by B cell E. All of the above 32. In the complement system A. Alternative pathway relys on antibody B. Classical pathway is best activated by bacterial endotoxin C. C1 is the first enzyme complex in the classical pathway D. Both the alternative and classical pathway converge at C2 E. The membrane attack complex is made up of C3a and C5a 33. Ig with binding site for C1q are A. IgE and IgD B. IgG and IgM C. IgM and IgA D. IgA and Ig G E. IgM and IgE 34. Prior to class switching, B-cells express A. IgA alone B. IgA and IgG C. IgM and IgD D. IgD alone E. No surface Ig 35. Interactions between _ are not restricted by MHC molecules A. Th cell & dendritic cell B. NK cell & target cell C. Tc cell & target cell D. Macrophage & Th cell E. Th cell & B cell 5 36. A major factor regulating the adaptive immune response is A. The granulocyte B. Complement membrane attack complex C. C-reactive protein D. Antigen concentration E. Platelet 37. Penicillin can cause A. Typehypersensitivity B. Type& hypersensitivity C. Type, &hypersensitivity D. Type, , & hypersensitivity E. Type & hypersensitivity 38. Which of the following is produced by CD4+ Th1 Cells? A. IL-2 receptor B. IL-8 C. C3 D. IL-4 E. IL-12 39. Rhesus hemolytic disease of the newborn involves A. IgE. B. Antibody to cell surfaces. C. Soluble immune complexes. D. Cytokine release from T-cells. E. Stimulatory antibodies. 40. Interferons A. Are found only in mammalian species B. Are divided into 5 main families C. Inhibit virus replication in the target cell D. Only affect infected cells E. Are specific for individual viruses . Answer questions (30 marks) 1. Please simply describe the biological functions of antibodies. (3 marks) 2. Please simply describe the functions of the important surface molecules of macrophages. (5 marks) 3. Please simply describe the general process of CD4+ T cell mediate immune response. (6 marks) 4. Please describe the structure, distribution and functions of HLA-molecules. (6 marks) 5. Please compare the components and mechanisms of type and hypersensitivity. (10 marks) 6 The Answers for the Final Examination of Immunology (A) -For 89K Seven-year Program (2005. 5) . Concepts (2.5 marks / concept, totally 20 marks) 1. Epitope: the smallest unit of an antigen to which an antibody or cell can bind. 2. Superantigen: molecules that polyclonally activate a large fraction of the T cells by binding to MHC class II molecules and T-cell receptors. 3. Positive selection: thymocytes in the cortex of thymus with TCRs with a moderate affinity for self-MHC molecules on epithelial cells are allowed to develop further. Others undergo apoptosis and die. MHC restriction. 4. Idiotype: are unique antigenic determinants associated with antigen binding sites of antibodies and are the results of the different amino acid sequences which determine their specificities. 5. APC: is a cell that displays peptide fragment of protein antigens, in association with MHC molecules, on its surface and activates antigen-specific T cells. 6. Hypersensitivity: refer to the tissue damage or functional disturbance that occurs as an overreaction by the immune system to a variety of antigens encountered on a second occasion. 7. Fab: fragment antigen binding. Complete L chain paired with the VH and CH1 domains of the H chain 8. McAb: monoclonal antibodies which are produced by a single clone of B cell hybridoma and are homogenous in structure and specificity. 7 . Fill each of the blank spaces with suitable words. (0.5 mark/blank space, totally 10 marks) 1. TNF, IL-1, IL-6, IL-8, IL-12 (位置可互换) 2. Tc, NK, Macrophage, neurophile，eosinophile，(其中任选三个,位置可互换) 3. Alternative, MBL, MBL, Alternative 4. NK, Macrophage, neurophile，B cell, eosinophile，pletellete (其中任选四个, 位置可互换) 5. IFN，IL-12, IL-4, IL-10 . For each of the following questions, choose the ONE BEST answer or completion. (0.5 mark / question, totally 20 marks) 1. C 2. B 3. E 4. C 5. B 6. C 7. A 8. D 9 .B 10. A 11. B 12. E 13. A 14. D 15. B 16. D 17. C 18. A 19. E 20. C 21. E 22. C 23. B 24. A 25.C 26. D 27. B 28. B 29. C 30. A 31. D 32. C 33. B 34. C 35. B 36. D 37. D 38. A 39. B 40. C 8 . Answer questions (30 marks) 1. Please simply describe the biological functions of antibodies. (3 marks) Biological functions of Ab 1) .5Bind specific with antigens. 2) .5complement activation 3) .5Opsonization 4) .5ADCC 5) .5Mediating type hypersensitivities: 6) .5Placental transfer and mucosal transfer 2. Please simply describe the functions of the important surface molecules of macrophages. (5 marks) (1).1Molecules involved in phagocytosis: 1Scavenger receptors, mannose receptor