1. What is the study of how the body fights disease and infection called?

A. Pathology

B. Immunology

C. Hematology

D. Microbiology

Answer: B. Immunology

2. What is the ability of the body to protect against foreign bodies called?

A. Resistance

B. Tolerance

C. Immunity

D. Infection

Answer: C. Immunity

3. Which of the following is NOT a type of immunity?

A. Natural

B. Artificial

C. Emotional

D. Adaptive

Answer: C. Emotional

4. Passive natural immunity is acquired through:

A. Vaccination
B. Infection

C. Antibody transfer from mother

D. Toxoid administration

Answer: C. Antibody transfer from mother

5. Which type of immunity results from infection?

A. Artificial passive

B. Natural active

C. Artificial active

D. Natural passive

Answer: B. Natural active

6. Which of the following crosses the placental barrier and causes congenital infections?

A. Streptococcus

B. HIV

C. Salmonella

D. E. coli

Answer: B. HIV

7. Malnutrition affects immunity by lowering:

A. Only humoral immunity

B. Only cell-mediated immunity

C. Both humoral and cell-mediated immunity

D. Only antibody levels

Answer: C. Both humoral and cell-mediated immunity

8. Which vitamin deficiency increases susceptibility to infection?

A. Vitamin D

B. Vitamin B12

C. Vitamin C

D. Vitamin K

Answer: C. Vitamin C

9. Which condition does NOT increase susceptibility to microbial infections?

A. Diabetes mellitus

B. Pregnancy

C. Hypertension

D. Adrenal dysfunction

Answer: C. Hypertension

10. Which of the following is NOT an anatomic barrier?

A. Saliva

B. Tears

C. Gastric acid

D. Mucus

Answer: C. Gastric acid

11. What is the role of cilia in the respiratory tract?

A. Destroy microbes

B. Propels mucus and trapped microorganisms

C. Produce antibodies

D. Secrete lysozyme

Answer: B. Propels mucus and trapped microorganisms

12. Which normal flora competes with pathogens for nutrients and attachment sites?

A. Harmful bacteria

B. Commensal organisms

C. Pathogenic fungi

D. Protozoa

Answer: B. Commensal organisms

13. Which physiological barrier is involved in killing ingested microbes?

A. Tears

B. Sweat

C. Gastric acidity

D. Mucus

Answer: C. Gastric acidity

14. What substance in secretions acts on bacterial cell walls?

A. Interferon

B. Lysozyme

C. Complement

D. IgG

Answer: B. Lysozyme

15. Interferons are secreted in response to:

A. Bacteria

B. Protozoa

C. Viral products

D. Fungi

Answer: C. Viral products

16. What percentage of peripheral blood lymphocytes are NK cells?

A. 1–2%

B. 5–10%

C. 20–30%

D. 50–60%

Answer: B. 5–10%

17. Neutrophils are classified as:

A. Mononuclear leukocytes

B. Basophils
C. Polymorphonuclear leukocytes

D. Eosinophils

Answer: C. Polymorphonuclear leukocytes

18. What is the lifespan of monocytes in the blood?

A. 2–4 hours

B. 8–12 hours

C. 10–20 hours

D. 48–72 hours

Answer: C. 10–20 hours

19. Which of the following becomes macrophages after entering tissues?

A. Neutrophils

B. Lymphocytes

C. Monocytes

D. Basophils

Answer: C. Monocytes

20. Kupffer cells are located in the:

A. Spleen

B. Lung

C. Liver

D. Brain
Answer: C. Liver

21. Alveolar macrophages are found in the:

A. Heart

B. Kidney

C. Lung

D. Brain

Answer: C. Lung

22. Which of the following is NOT a step of phagocytosis?

A. Activation

B. Chemotaxis

C. Vaccination

D. Ingestion

Answer: C. Vaccination

23. Which enzyme converts oxygen into superoxide anion?

A. Catalase

B. Oxidase

C. Lysozyme

D. Elastase

Answer: B. Oxidase
24. Which of the following is oxygen-independent killing mechanism?

A. Superoxide anion

B. Hydrogen peroxide

C. Defensins

D. Hydroxyl radicals

Answer: C. Defensins

25. Bacteria may evade phagocytosis by:

A. Releasing toxins only

B. Living in accessible areas

C. Growing in inaccessible regions

D. Binding antibodies

Answer: C. Growing in inaccessible regions

26. Inflammation causes all of the following EXCEPT:

A. Redness

B. Pain

C. Numbness

D. Swelling

Answer: C. Numbness

27. Which is NOT a mediator of inflammation?

A. Histamine

B. Kinins
C. Albumin

D. Defensins

Answer: C. Albumin

28. Which is a primary lymphoid organ?

A. Lymph nodes

B. Tonsils

C. Bone marrow

D. Spleen

Answer: C. Bone marrow

29. Peyer’s patches are part of:

A. Primary lymphoid organs

B. Skin-associated lymphoid tissue

C. MALT

D. Circulatory system

Answer: C. MALT

30. The immune system differentiates self from non-self using:

A. Cytokines

B. Hormones

C. Pattern recognition receptors

D. Interferons
Answer: C. Pattern recognition receptors

31. T-cell receptors are:

A. Germline encoded

B. Somatically generated

C. Antibodies

D. Hormones

Answer: B. Somatically generated

32. Neutrophils respond first in:

A. Chronic inflammation

B. Viral infection

C. Inflammation

D. Allergy

Answer: C. Inflammation

33. Which cell is responsible for allergic inflammation?

A. Eosinophils

B. Neutrophils

C. Macrophages

D. T cells

Answer: A. Eosinophils
34. Basophils are responsible for:

A. Phagocytosis

B. Antigen presentation

C. Anaphylactic reactions

D. Viral killing

Answer: C. Anaphylactic reactions

35. Class I MHC molecules are found on:

A. RBCs

B. All nucleated cells

C. Platelets

D. Only APCs

Answer: B. All nucleated cells

36. Class II MHC molecules are found on:

A. RBCs

B. All cells

C. Antigen presenting cells

D. T cells only

Answer: C. Antigen presenting cells

37. MHC in humans is known as:

A. MALT
B. CD markers

C. HLA

D. APC

Answer: C. HLA

38. MHC class III genes encode:

A. Cell surface receptors

B. Cytokines

C. Complement proteins

D. T-cell receptors

Answer: C. Complement proteins

39. Dendritic cells are primarily involved in:

A. Cytotoxicity

B. Inflammation

C. Antigen presentation

D. Histamine release

Answer: C. Antigen presentation

40. Plasma cells secrete:

A. Cytokines

B. Antigens

C. Immunoglobulins
D. Enzymes

Answer: C. Immunoglobulins

41. Which cell produces all classes of antibodies?

A. T cells

B. B cells

C. NK cells

D. Plasma cells

Answer: D. Plasma cells

42. Which immune cell can kill virally infected cells without sensitization?

A. B cell

B. T helper cell

C. NK cell

D. Dendritic cell

Answer: C. NK cell

43. Eosinophils kill parasites using:

A. Hydrolytic enzymes

B. Lysozyme

C. Complement

D. Perforin

Answer: A. Hydrolytic enzymes

44. Which MHC class interacts with cytotoxic T cells?

A. Class I

B. Class II

C. Class III

D. Class IV

Answer: A. Class I

45. Which MHC class interacts with helper T cells?

A. Class I

B. Class II

C. Class III

D. Class IV

Answer: B. Class II

46. What does APC stand for?

A. Antibody Producing Cell

B. Antigen Presenting Cell

C. Adaptive Processing Center

D. Activated Plasma Cell

Answer: B. Antigen Presenting Cell

47. The process of engulfing microbes is called:

A. Endocytosis

B. Pinocytosis

C. Phagocytosis

D. Exocytosis

Answer: C. Phagocytosis

48. What promotes enhanced phagocyte attachment to microbes?

A. Peptidoglycan

B. Cilia

C. IgG and C3b

D. Lysozyme

Answer: C. IgG and C3b

49. What organelle merges with phagosomes during digestion?

A. Golgi apparatus

B. Ribosomes

C. Lysosomes

D. Nucleus

Answer: C. Lysosomes

50. Which of the following is a function of macrophages?

A. Produce antibodies

B. Release histamine
C. Antigen presentation

D. Neutralize toxins

Answer: C. Antigen presentation

Acquired Immunity – Multiple Choice Questions (MCQ)

1. Which of the following best defines acquired immunity?

A) Immunity present at birth

B) Nonspecific defense mechanism

C) Immunity developed after birth mediated by antibodies or lymphocytes ✔

D) Immunity caused by physical barriers

2. What are the main cellular components of acquired immunity?

A) Neutrophils and eosinophils

B) B and T lymphocytes ✔

C) Monocytes and macrophages

D) Basophils and mast cells

3. The ability of the immune system to distinguish between self and non-self is called:

A) Specificity

B) Discrimination ✔

C) Diversity

D) Memory

4. Which feature of acquired immunity allows a faster response during the second encounter
with the same antigen?

A) Diversity

B) Memory ✔

C) Specificity
 D) Self-tolerance

5. T lymphocytes are derived from which organ?

A) Thymus ✔

B) Bone marrow

C) Liver

D) Lymph nodes

6. What is the typical percentage of T cells among circulating lymphocytes?

A) 20–35%

B) 40–55%

C) 65–80% ✔

D) 85–100%

7. T cells are commonly identified in labs by their ability to form rosettes with:

A) Bacteria

B) Sheep red blood cells ✔

C) Antigens

D) Plasma cells

8. Which T cells regulate and suppress immune responses?

A) Helper T cells

B) Cytotoxic T cells

C) Regulatory T cells ✔

D) Memory T cells

9. Memory T cells:

A) Live for a few days

 B) Provide faster and stronger secondary immune response ✔

C) Require more stimulation than naïve cells

D) Do not produce interleukins

10. What is the function of suppressor T cells?

A) Inhibit cytotoxic and helper T cells ✔

B) Destroy antigens directly

C) Produce antibodies

D) Stimulate memory B cells

11. The term “antigen” stands for:

A) Anti-toxin

B) Antibody generator ✔

C) Anti-microbe

D) Anti-cell

12. Haptens are:

A) Antigens that are not immunogenic by themselves ✔

B) Toxins

C) Cytokines

D) Memory molecules

13. The ability of an antigen to bind with antibodies is called:

A) Antigenicity ✔

B) Immunogenicity

C) Specificity

D) Recognition
14. Which of the following is not a determinant of antigenicity?

A) Molecular size

B) Blood pH ✔

C) Foreignness

D) Chemical complexity

15. Epitopes are:

A) Entire antigen molecules

B) Specific parts of an antigen that bind antibodies ✔

C) Receptors on T cells

D) Types of B cells

16. Protein antigens are more immunogenic than polysaccharides because:

A) They are smaller

B) They are less stable

C) They are chemically more complex ✔

D) They are neutral in charge

17. Which of the following antigen types is produced inside the body?

A) Exogenous

B) Endogenous ✔

C) Foreign

D) Artificial

18. Which antigen type is associated with autoimmune diseases?

A) Autoantigens ✔

B) Exogenous
 C) Endogenous

D) Hapten

19. Superantigens activate:

A) A few specific T cells

B) A large proportion of T cells (up to 25%) ✔

C) Only B cells

D) Only memory cells

20. Which of the following is an example of a superantigen?

A) Hepatitis virus

B) Staphylococcal enterotoxin ✔

C) Interleukin-2

D) Histamine

21. Antibodies are also called:

A) Leukocytes

B) Immunoglobulins ✔

C) Antigens

D) Hormones

22. Which is not a function of antibodies?

A) Neutralizing toxins

B) Activating complement

C) Producing red blood cells ✔

D) Facilitating phagocytosis

23. An antibody consists of:

 A) 2 light chains

B) 2 heavy chains

C) 2 heavy + 2 light chains (H2L2) ✔

D) 4 heavy chains

24. The flexible part of the antibody molecule is:

A) Fab region

B) Hinge region ✔

C) Fc region

D) Constant region

25. Antigen-binding sites are located in which region of the antibody?

A) Fab ✔

B) Fc

C) Constant

D) Hinge

26. Which antibody region binds to receptors on immune cells?

A) Fab

B) Fc ✔

C) Variable region

D) Light chain

27. What type of bonds hold the antigen to the antibody?

A) Covalent

B) Non-covalent ✔

C) Peptide
 D) Ester

28. Which of the following is not a non-covalent bond in antigen-antibody binding?

A) Hydrogen bond

B) Van der Waals forces

C) Hydrophobic bond

D) Disulfide bond ✔

29. The concept describing antigen-antibody fit is:

A) Lock-breaking

B) Lock and key ✔

C) Bond theory

D) Chain reaction

30. The part of the antibody that crystallizes is called:

A) Fab

B) Fc ✔

C) Variable region

D) Light chain

31. Which cells are involved in antigen presentation?

A) Antigen-presenting cells (APCs) ✔

B) Red blood cells

C) Mast cells

D) Erythrocytes

32. B cells mature in the:

A) Bone marrow ✔
 B) Thymus

C) Lymph nodes

D) Spleen

33. The first exposure to an antigen causes a:

A) Secondary response

B) Primary response ✔

C) Passive response

D) Delayed response only

34. Secondary immune responses are:

A) Slower

B) Faster and stronger ✔

C) Weaker

D) Absent

35. TCRs recognize antigens presented by:

A) MHC molecules ✔

B) RBCs

C) IgE molecules

D) CD4 alone

36. Which class of immunoglobulin is most abundant in blood?

A) IgG ✔

B) IgA

C) IgM

D) IgE
37. The variable region of an antibody is important for:

A) Antigen binding ✔

B) Complement activation

C) Flexibility

D) Crystallization

38. Which of the following is the function of the Fc region?

A) Interacts with immune cells and activates complement ✔

B) Binds directly to antigens

C) Changes antibody shape

D) Prevents phagocytosis

39. Antigens are mainly captured and processed by:

A) T cells

B) Antigen-presenting cells ✔

C) Neutrophils

D) Plasma cells

40. Which cell type helps activate B cells?

A) Helper T cells ✔

B) Suppressor T cells

C) Memory B cells

D) Mast cells

41. B cells differentiate into:

A) T helper cells

B) Plasma cells ✔
 C) Macrophages

D) Dendritic cells

42. What is the smallest unit of antigen recognition?

A) Whole antigen

B) Epitope ✔

C) Fc fragment

D) Antibody

43. Which type of antigen originates outside the body?

A) Exogenous ✔

B) Endogenous

C) Autoantigen

D) Self-antigen

44. Blood group antigens are considered:

A) Superantigens

B) Endogenous antigens ✔

C) Autoantigens

D) Exogenous antigens

45. Which factor does not influence immunogenicity?

A) Size

B) Complexity

C) Foreignness

D) Osmotic pressure ✔

46. Intracellular viruses are considered:

 A) Autoantigens

B) Endogenous antigens ✔

C) Exogenous antigens

D) Haptens

47. Which cells are responsible for immune memory?

A) Naïve T cells

B) Memory T cells ✔

C) Neutrophils

D) Eosinophils

48. Which of the following promotes phagocytosis by antibodies?

A) Fc region only

B) Opsonization ✔

C) Suppression

D) Endocytosis

49. Which molecule is required for TCR recognition of antigen?

A) MHC ✔

B) Antibody

C) Cytokine

D) Fc receptor

50. Which immunoglobulin structure includes a hinge region for flexibility?

A) IgE

B) IgD

C) IgG ✔
 D) IgM

Tolerance, Autoimmunity, Immunodeficiency, and Immunization – MCQs

1. What is tolerance in immunology?

o A. Reactivity to all antigens
o ✔️B. Specific non-reactivity to an antigen after previous exposure
o C. Enhanced immune response to non-self
o D. Inability to produce antibodies
2. A substance that induces tolerance is called:
o A. Autoantigen
o B. Antibody
o ✔️C. Tolerogen
o D. Allergen
3. Which of the following diseases demonstrates tolerance to a pathogen?
o A. Tuberculosis
o ✔️B. Lepromatous leprosy
o C. AIDS
o D. Rheumatoid arthritis
4. Autoimmunity results from:
o A. Tolerance to non-self
o ✔️B. Breakdown of self-tolerance mechanisms
o C. Tolerance to all antigens
o D. Overactive phagocytosis
5. Which of the following is not always harmful in autoimmunity?
o A. Self-reactive T cells
o ✔️B. Anti-idiotype antibodies
o C. Immune complexes
o D. Autoantibodies against DNA
6. Immunodeficiency is defined as:
o A. Overactive immune response
o B. Autoimmunity against self
o ✔️C. Failure of immune system to protect against disease
o D. Inability to recognize antigens
7. Primary immunodeficiencies are:
o A. Acquired later in life
o ✔️B. Present at birth due to genetic or developmental defects
o C. Always viral in origin
o D. Caused by aging
8. Secondary immunodeficiencies may be caused by:
o A. Genetics
o ✔️B. Environmental factors
o C. Fetal development
o D. All of the above
9. AIDS is an example of:
 o A. Primary immunodeficiency
o ✔️B. Secondary immunodeficiency
o C. Autoimmunity
o D. Tolerance disorder
10. HIV is classified as a:
o A. DNA virus
o ✔️B. Retrovirus
o C. Bacteriophage
o D. RNA bacterium
11. The enzyme responsible for converting HIV RNA to DNA is:
o ✔️A. Reverse transcriptase
o B. Protease
o C. Integrase
o D. Polymerase
12. HIV primarily infects:
o ✔️A. CD4+ T cells
o B. B cells
o C. Macrophages only
o D. NK cells
13. The critical CD4+ count for AIDS diagnosis is:
o A. 500/mm³
o ✔️B. 200/mm³
o C. 1000/mm³
o D. 50/mm³
14. What type of infections initially revealed AIDS in 1981?
o A. Bacterial pneumonia
o ✔️B. Fungal infections and Kaposi’s sarcoma
o C. Viral hepatitis
o D. Parasitic diarrhea
15. HIV viral DNA is integrated into the host genome as:
o A. Plasmid
o ✔️B. Provirus
o C. Episome
o D. Virion
16. Which virus type is most common globally?
o A. HIV-2
o ✔️B. HIV-1
o C. HSV-1
o D. EBV
17. Artificially acquired passive immunity includes:
o A. Live vaccines
o B. Killed vaccines
o ✔️C. Injection of gamma globulins
o D. Natural antibodies
18. Passive immunity provides:
 o A. Lifelong protection
o ✔️B. Immediate but temporary protection
o C. Delayed response
o D. Cell memory response
19. Gamma-globulin therapy is used in:
o A. Autoimmune diseases only
o ✔️B. Acute infections and poisonings
o C. Cancer only
o D. Allergy treatments
20. A disadvantage of heterologous gamma-globulin therapy is:
o ✔️A. Risk of serum sickness
o B. Long-term immunity
o C. Activation of memory T cells
o D. No immune reaction
21. Homologous gamma globulin may carry the risk of:
o A. Influenza
o ✔️B. Hepatitis and HIV
o C. Pneumonia
o D. Malaria
22. Passive transfer of cell-mediated immunity is:
o ✔️A. Possible but risky
o B. Safe and routine
o C. Ineffective
o D. Common in vaccines
23. A major risk of cell transfer therapy is:
o A. Cancer relapse
o B. HIV transmission
o ✔️C. Graft versus host disease
o D. Hemolytic anemia
24. One challenge in cell-mediated therapy is:
o A. No matching needed
o B. Easy donor availability
o ✔️C. Difficulty in finding histocompatible donors
o D. Long-term side effects
25. What type of immunity uses T cells and antibodies?
o A. Innate immunity
o ✔️B. Adaptive immunity
o C. Passive immunity
o D. Local immunity
26. Immunization primarily works by:
o A. Injecting live virus
o ✔️B. Stimulating immune response to pathogen or toxin
o C. Removing T cells
o D. Blocking receptors
27. Which immunoglobulin source is preferred in passive immunization?
 o A. Plant-derived antibodies
o B. Rabbit serum
o ✔️C. Human origin
o D. Mouse hybridomas
28. Passive immunization is commonly used in:
o A. Hypertension
o ✔️B. Rabies and tetanus
o C. Diabetes
o D. Migraine
29. Autoimmunity can lead to:
o A. Tolerance to bacteria
o ✔️B. Immune attack against self-tissues
o C. Increased B-cell maturation only
o D. Weak T cell activation
30. Which of the following is an example of secondary immunodeficiency?
o A. SCID
o B. DiGeorge syndrome
o ✔️C. HIV infection
o D. Agammaglobulinemia