Immunopathology Practice Questions

Q: Which of the following is a large granular lymphocyte?

NK cell. ### Explanation **Correct Option: A (NK cell)** Natural Killer (NK) cells are the classic example of **Large Granular Lymphocytes (LGLs)**. Morphologically, they are larger than resting B or T cells and possess a characteristic abundant pale cytoplasm containing distinct azurophilic (proteolytic) granules. These granules contain **perforins and granzymes**, which are essential for the NK cell's primary function: inducing apoptosis in virally infected or tumor cells without prior sensitization (Innate Immunity) [1]. **Incorrect Options:** * **B & C (B and T-lymphocytes):** Most circulating B and T cells are **small lymphocytes**. They have a high nuclear-to-cytoplasmic (N:C) ratio, a thin rim of agranular cytoplasm, and dense chromatin. While some activated T-cells (CD8+ cytotoxic T-cells) can appear as LGLs, NK cells are the definitive answer for this classification in standard pathology. * **D (Macrophage):** Macrophages are derived from monocytes and are part of the myeloid lineage, not the lymphoid lineage. They are much larger than lymphocytes and possess a kidney-shaped nucleus with vacuolated cytoplasm, rather than the specific "large granular lymphocyte" morphology. **High-Yield Clinical Pearls for NEET-PG:** * **Surface Markers:** NK cells are identified by the presence of **CD56** and **CD16** (Fc̲RIII) and the **absence of CD3**. * **Mechanism:** They utilize **KIRs (Killer Cell Immunoglobulin-like Receptors)** to detect the absence of MHC Class I molecules on target cells ("Missing Self" hypothesis) [1]. * **LGL Leukemia:** A rare lymphoproliferative disorder characterized by a persistent increase in large granular lymphocytes, often associated with rheumatoid arthritis and neutropenia (Felty’s syndrome). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 200-201.

Question 1

What is the prototype of type-II hypersensitivity reaction?

Accepted Answer

Autoimmune hemolytic anemia

Answer

Arthus reaction

Answer

Systemic lupus erythematosus

Answer

Contact dermatitis

Question 2

Immunosuppressive drugs are less effective in which type of graft rejection?

Accepted Answer

Acute humoral rejection

Answer

Acute cellular rejection

Answer

Chronic rejection

Answer

None of the above

Question 3

Which is considered the best serological marker for Systemic Lupus Erythematosus (SLE)?

Accepted Answer

Anti-ds DNA antibodies

Answer

Anti-Sm antibodies

Answer

Anti-Histone antibodies

Answer

Anti-Ro (SS-A) antibodies

Question 4

Local lymph nodules are enlarged near an infected wound. Histological examination reveals an increased amount of macrophages, lymphocytes, lymphatic follicles in the cortical layer, and a large amount of plasma cells. What process in the lymphatic nodules represents these histological changes?

Accepted Answer

Antigen stimulation

Answer

Acquired insufficiency of the lymphoid tissue

Answer

Tumour transformation

Answer

Innate insufficiency of the lymphoid tissue

Question 5

Which of the following is a large granular lymphocyte?

Accepted Answer

NK cell

Answer

B-lymphocyte

Answer

T-lymphocyte

Answer

Macrophage

Question 6

Which granulomatous condition is associated with hypercalcemia?

Accepted Answer

Sarcoidosis

Answer

Tuberculosis

Answer

Berylliosis

Answer

Systemic Lupus Erythematosus

Question 7

Which of the following is NOT a feature of DiGeorge syndrome?

Accepted Answer

B cell defect

Answer

Results from failure of development of the third and fourth pharyngeal pouches

Answer

Absent thyroid

Answer

Absent parathyroid glands

Question 8

Which of the following is an autoimmune disease?

Accepted Answer

All of the above

Answer

Sjogren's syndrome

Answer

Mikulicz's disease

Answer

Rheumatoid arthritis

Question 9

Graft versus host disease is due to?

Accepted Answer

Immunocompetent T cells in graft tissue

Answer

Immunocompetent T cells in host

Answer

Immunocompetent B cells in graft tissue

Answer

Immunocompetent B cells in host

Question 10

Onion skin spleen is seen in which of the following conditions?

Accepted Answer

Systemic Lupus Erythematosus (SLE)

Answer

Sjogren's syndrome

Answer

Thrombotic thrombocytopenic purpura

Answer

Henoch Schonlein purpura

Immunopathology — MCQs

Immunopathology — MCQs

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