Internal Medicine
1 questionsWhich condition is not associated with complement deficiency?
NEET-PG 2015 - Internal Medicine NEET-PG Practice Questions and MCQs
Question 871: Which condition is not associated with complement deficiency?
- A. SLE
- B. PNH
- C. Membranous nephritis (Correct Answer)
- D. Hereditary angioedema
Explanation: Membranous nephritis - Membranous nephritis is associated with immune complex deposition rather than complement deficiencies. [1] - The disease is characterized by thickening of the glomerular basement membrane without significant complement involvement. [1] PNH - Paroxysmal nocturnal hemoglobinuria (PNH) is due to a defect in the GPI-anchor leading to complement-mediated hemolysis. - Complement activation plays a critical role in the destruction of red blood cells in this condition. Hereditary angioedema - Hereditary angioedema is caused by deficiencies in C1 inhibitor, leading to uncontrolled activation of complement. - This results in edema episodes, directly linked to complement pathway dysregulation. SLE - Systemic lupus erythematosus (SLE) involves complement consumption due to autoantibody formation against nuclear antigens. - The disease often presents with hypocomplementemia, indicating complement system involvement.
Microbiology
8 questionsWhich human IgG subclass has the highest serum concentration?
Which of the following does not stimulate active immunity?
Which of the following is a specific feature of acquired immunity?
Lattice phenomenon is seen in which of the following?
To which part of an antigen do monoclonal antibodies specifically bind?
What type of immunity is primarily associated with the administration of transfer factor?
Which of the following tests is not classified as an in vivo test?
In human infections, the morula form is seen in which of the following organisms?
NEET-PG 2015 - Microbiology NEET-PG Practice Questions and MCQs
Question 871: Which human IgG subclass has the highest serum concentration?
- A. IgG1 (Correct Answer)
- B. IgG2
- C. IgG3
- D. IgG4
Explanation: ***IgG1*** - **IgG1** constitutes approximately **60-70%** of the total IgG in human serum, making it the most abundant subclass. - Its high concentration reflects its crucial role in **neutralizing toxins**, agglutinating viruses, and opsonizing bacteria for phagocytosis. *IgG2* - **IgG2** makes up about **20-30%** of total IgG and is primarily important in protecting against **polysaccharide-encapsulated bacteria**. - While significant, its serum concentration is notably lower than that of IgG1. *IgG3* - **IgG3** is the least abundant IgG subclass, accounting for only **5-8%** of total IgG, and is characterized by a shorter half-life. - Despite its low concentration, it is highly efficient in activating the **complement system** due to its flexible hinge region. *IgG4* - **IgG4** comprises approximately **3-6%** of total IgG and is unique for its ability to undergo **Fab arm exchange**, leading to bispecific antibodies. - It does not activate complement and is often associated with allergy and protection against parasitic infections, but its concentration is significantly less than IgG1.
Question 872: Which of the following does not stimulate active immunity?
- A. Clinical infection
- B. Vaccination
- C. Transplacental antibody transfer in newborn (Correct Answer)
- D. Subclinical infection
Explanation: ***Transplacental antibody transfer in newborn*** - This is a form of **passive immunity**, where pre-formed **antibodies from the mother** are transferred to the newborn, providing immediate but temporary protection. - It does not involve the newborn's own immune system generating an immune response or creating **memory cells**. *Subclinical infection* - Even without overt symptoms, a **natural infection** exposes the immune system to pathogens, triggering an active immune response and generating **memory cells**. - This leads to **long-term immunity** against future exposures to the same pathogen. *Clinical infection* - A **symptomatic natural infection** involves the immune system actively responding to the pathogen, producing antibodies and **memory cells**. - This process is the basis of **naturally acquired active immunity** and provides durable protection. *Vaccination* - Vaccines contain weakened or inactive forms of pathogens, or their components, which stimulate the immune system to produce **antibodies** and **memory cells** without causing disease. - This is an example of **artificially acquired active immunity**, providing long-lasting protection.
Question 873: Which of the following is a specific feature of acquired immunity?
- A. Immunological memory (Correct Answer)
- B. Affected by genetic makeup
- C. No antigen exposure
- D. Immediate response
Explanation: ***Immunological memory*** - A key characteristic of **acquired immunity** is the ability to "remember" previous encounters with specific pathogens. - This memory leads to a more rapid and robust immune response upon subsequent exposure to the same pathogen. - This is the **defining feature** that distinguishes acquired immunity from innate immunity. *Affected by genetic makeup* - While genetic makeup can influence the *efficiency* of the acquired immune system, it is not a **specific feature** that distinguishes it from innate immunity. - **Both innate and acquired immunity** are affected by genetic factors, determining baseline resistance and immune response capability. *No antigen exposure* - **Acquired immunity** is specifically characterized by its *dependence* on antigen exposure to develop specific responses. - The phrase "no antigen exposure" describes how the **innate immune system** functions, providing immediate, non-specific protection without prior contact with a pathogen. *Immediate response* - **Innate immunity** provides an immediate, non-specific response to pathogens. - **Acquired immunity** takes time to develop (days to weeks) after initial antigen exposure, but provides a faster response upon re-exposure due to immunological memory.
Question 874: Lattice phenomenon is seen in which of the following?
- A. Complement fixation test
- B. Precipitation test (Correct Answer)
- C. None of the options
- D. Neutralization reaction
Explanation: ***Precipitation test*** - The **lattice phenomenon** describes the formation of an interconnected network of antigen-antibody complexes, which is essential for visible precipitation to occur. - This phenomenon dictates that optimal precipitation requires a specific **antigen-to-antibody ratio**; an excess of either can lead to false-negative results due to soluble immune complexes (prozone or postzone effects). *Complement fixation test* - This test relies on the **binding of complement** to antigen-antibody complexes, leading to the lysis of indicator red blood cells if complement is not fixed. - It is a **two-stage test** that measures the consumption of complement, not the direct observation of a lattice. *None of the options* - This option is incorrect because the **precipitation test** clearly demonstrates the lattice phenomenon. - The formation of a visible precipitate is a direct result of antigen-antibody lattice formation. *Neutralization reaction* - Neutralization involves antibodies binding to toxins or viruses, **blocking their biological activity** rather than forming a visible precipitate. - It is a **functional assay** that measures the ability of antibodies to inhibit harmful effects, not the formation of large immune complexes.
Question 875: To which part of an antigen do monoclonal antibodies specifically bind?
- A. None of the options
- B. Specific epitope on the antigen (Correct Answer)
- C. Both the epitope and the paratope
- D. Part of the antibody that binds to the epitope
Explanation: ***Specific epitope on the antigen*** - Monoclonal antibodies are designed to recognize and bind to a **unique, specific region** on an antigen, known as an **epitope**. - This high specificity is crucial for their clinical applications, such as targeted therapies and diagnostic tests. *Both the epitope and the paratope* - The **epitope** is the part of the antigen, while the **paratope** is the part of the antibody that binds to the epitope. - An antibody binds to an epitope, not to both itself and its own binding site. *None of the options* - This option is incorrect because there is a correct answer among the choices provided, which accurately describes the binding site of monoclonal antibodies. *Part of the antibody that binds to the epitope* - This describes the **paratope**, which is the antigen-binding site on the antibody, not the part of the antigen to which the antibody binds. - The question specifically asks about the part of the antigen.
Question 876: What type of immunity is primarily associated with the administration of transfer factor?
- A. Natural active immunity
- B. Artificial active immunity
- C. Artificial passive immunity
- D. Adoptive immunity (Correct Answer)
Explanation: ***Adoptive immunity (Correct)*** - **Transfer factor** consists of small, dialyzable molecules extracted from immune T lymphocytes of an immune donor - Its administration transfers **cell-mediated immunity** from donor to recipient, which defines adoptive immunity - This represents transfer of **immune cells or their products** (not antibodies), providing antigen-specific cellular immunity - Also called **adoptive immunotherapy** or adoptive transfer *Artificial passive immunity (Incorrect)* - Involves the **transfer of pre-formed antibodies** (e.g., antitoxins, immunoglobulins, antiserum) from an immune individual or animal - Provides **immediate but temporary humoral protection** - Does NOT transfer cellular immunity - this is the key distinction from adoptive immunity - Examples: Anti-rabies immunoglobulin, anti-tetanus serum *Natural active immunity (Incorrect)* - Occurs when an individual is **naturally exposed to an antigen** (infection) and produces their own antibodies and immune cells - The host's own immune system **actively responds** to develop long-lasting immunity - Example: Immunity after recovering from measles or chickenpox *Artificial active immunity (Incorrect)* - Achieved through **vaccination** with attenuated, inactivated, or subunit antigens - The recipient's body is **actively stimulated** to produce protective immunity - Provides long-lasting protection through immunological memory
Question 877: Which of the following tests is not classified as an in vivo test?
- A. Schick test
- B. Elek's gel precipitation test (Correct Answer)
- C. Tuberculin test
- D. Lepromin test
Explanation: ***Elek's gel precipitation test*** - This test is an **in vitro** method used to detect the production of **diphtheria toxin** by *Corynebacterium diphtheriae* strains in a lab setting, not within a living organism. - It involves the precipitation of toxin and antitoxin in an agar gel, forming visible lines. *Schick test* - The Schick test is an **in vivo** test used to determine susceptibility to **diphtheria** by injecting diphtheria toxin subcutaneously and observing for a localized inflammatory reaction. - A positive reaction (inflammation) indicates a lack of protective antitoxin antibodies. *Lepromin test* - The Lepromin test is an **in vivo** test used to assess the type of **leprosy** a patient has and to evaluate their cell-mediated immune response to *Mycobacterium leprae*. - It involves the intradermal injection of lepromin antigen and observing for a delayed hypersensitivity reaction. *Tuberculin test* - Also known as the **Mantoux test**, this is an **in vivo** test used to screen for exposure to **tuberculosis** by injecting purified protein derivative (PPD) intradermally. - A positive reaction indicates a **cell-mediated immune response** to *Mycobacterium tuberculosis*.
Question 878: In human infections, the morula form is seen in which of the following organisms?
- A. Chlamydiae
- B. Bartonella quintana
- C. Mycoplasma hominis
- D. Ehrlichia (Correct Answer)
Explanation: ***Correct: Ehrlichia*** - *Ehrlichia* species are **obligate intracellular bacteria** that replicate in host immune cells, forming distinctive microcolonies known as **morulae** (mulberry-like clusters). - The presence of morulae within the cytoplasm of **white blood cells** (monocytes or granulocytes) is the **key diagnostic feature** for ehrlichiosis. - The term "morula" comes from Latin for "mulberry," describing the characteristic clustered appearance visible on microscopy. *Incorrect: Chlamydiae* - *Chlamydiae* are obligate intracellular parasites with a unique developmental cycle involving elementary bodies (infectious form) and reticulate bodies (replicative form). - They form **intracytoplasmic inclusions** within vacuoles, but these are **not morulae**. *Incorrect: Bartonella quintana* - *Bartonella quintana* is a fastidious gram-negative bacillus associated with **trench fever** and bacillary angiomatosis. - Typically seen as individual or small clusters of bacteria, but **does not form morulae** within host cells. *Incorrect: Mycoplasma hominis* - *Mycoplasma hominis* is a small, **wall-less bacterium** that can cause genitourinary infections. - It is an extracellular pathogen or adheres to host cells but **does not invade or form intracytoplasmic morulae**.
Pathology
1 questionsIndirect Coombs test detects:
NEET-PG 2015 - Pathology NEET-PG Practice Questions and MCQs
Question 871: Indirect Coombs test detects:
- A. Antibodies in the serum (Correct Answer)
- B. Antibodies bound to RBC Surface
- C. Antigens bound to RBC Surface
- D. Antigens in the plasma
Explanation: ***Antibodies in the serum*** - The **indirect Coomb's test** is designed to detect the presence of **antibodies** against red blood cells (RBCs in the serum) before transfusion or during pregnancy [1]. - It is crucial in identifying **hemolytic disease of the newborn** (HDN) and ensuring safe blood transfusions [1]. *Antibodies attached to RBC Surface* - This scenario describes the **direct Coomb's test**, which identifies antibodies that are already bound to **RBCs**. - Direct testing assesses conditions like **autoimmune hemolytic anemia**, not the serum. *Antigens attached to RBC Surface* - This option suggests evaluating **antigens** present on the surface of RBCs, which is not the purpose of the indirect Coomb's test. - Antigens are important in blood typing and compatibility assessments, but this test focuses on antibodies. *Antigens in the serum* - Indirect Coomb's does not detect **antigens** but rather the **antibodies** related to those antigens. - Additionally, serum testing for antigens is not a standard procedure for assessing transfusion compatibility. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 627-628.