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Biology and Human Welfare

Description: This test will boost the knowledge of the students about the topic and will help them for preparing their exams in a much better way.
Number of Questions: 100
Created by:
Tags: Cancer and AIDS AID and Cancer -- Causes and Control
Attempted 0/100 Correct 0 Score 0

A young woman of 32 is found to have a largely solid ovarian neoplasm. Tumor markers were obtained and demonstrated a markedly elevated LDH value. The hCG and a-Fetoprotein were negative. Which of the following tumors is the most likely histology for this neoplasm?

  1. Dysgerminomas

  2. Gonadoblastoma

  3. Immature teratomas

  4. Choriocarcinoma

  5. Endodermal sinus tumor


Correct Option: A
Explanation:

Dysgerminomas, the most frequent germ cell malignancy, are principally solid. Such tumors are most frequent in women with dysgenetic gonads. Pure ovarian dysgerminomas cause an elevated LDH with normal hCG and a-fetoprotein levels.

Mutation in the RET oncogene is associated with increased risk of

  1. endometrial cancer

  2. PNET cancer

  3. prostate cancer

  4. adenocarcinoma

  5. medullary thyroid cancer


Correct Option: A
Explanation:

Endometrial cancer begins in the layer of cells that form the lining (endometrium) of the uterus. The causes of endometrial cancer are still unknown.

The majority of ovarian epithelial cancers occurring on a hereditary basis originates in a woman with germline mutations in which of the following genes?

  1. pRb

  2. MSH2

  3. p53

  4. BRCA 1

  5. BRCA 2


Correct Option: D
Explanation:

Mutations in the BRCA 1 gene (located on chromosome 17) cause most of the ovarian epithelial cancers seen on a hereditary basis.

A CA 125 test may be used to monitor certain cancers during and after treatment. CA 125 is

  1. a tumor specific transplantation antigen

  2. a mucin-type glycoprotein

  3. a ganglioside

  4. useful for ovarian cancer screening in the general patient population

  5. an antigen which is frequently expressed by mucinous ovarian carcinomas


Correct Option: B
Explanation:

CA 125 is a mucin-type glycoprotein which is usually not expresses by mucinous tumors. The antigen (CA 25) is expressed by fetal amniotic and coelomic epithelium.

Which among the following statements characterises lung cancer in an individual?

  1. Screening test has been proved beneficial.

  2. More than 80% are due to smoking.

  3. In the patients of lung cancers, around 30% are large cell anaplastic.

  4. The second lung cancer is rare in an individual.

  5. Lung cancer does not produce pain in the chest.


Correct Option: B
Explanation:

It is correct. 80% cases of lung cancer are due to smoking.Cigarette smoking is the most important cause of lung cancer. Cigarette smoke contains more than 5,000 chemicals, many of which are cancer causing.

Defects in neutrophil NADPH oxidase system causes which among the following diseases in human beings?

  1. Chronic granulomatous disease

  2. Chediak-Higashi disease

  3. Leukocyte adhesion deficiency

  4. Hashimoto's disease

  5. Streptococcal infection


Correct Option: A
Explanation:

There is a failure to make reactive oxygen intermediates and to raise the pH in the phagocytic vacuole which facilitates microbicidal action.

Which of the following is most commonly seen in African children with Burkitt's lymphoma?

  1. Chromosome 8q24 to Chromosome 2p12 translocation

  2. Chromosome 8q24 to Chromosome 14q32 translocation

  3. Deletion of the c-myc gene

  4. T-cell neoplasia

  5. Absence of EBV


Correct Option: B
Explanation:

The c-myc gene (chromosome 8q24) involved in the entry of cells from resting G0 into the cell cycle is translocated to the mu heavy chain gene (chromosome 14q32) in most cases of Burkitt's lymphoma studied.

HIV is the infection that causes AIDS. To which of the following receptors of human beings does the HIV bind itself?

  1. CD4

  2. IL-2 receptor

  3. NF kappa B

  4. Reverse transcriptase

  5. TNF receptors


Correct Option: A
Explanation:

The HIV envelope protein gp120 binds to CD4. This targets the virus to this T-cell subset.

Strongly immunogenic tumors appear

  1. in virtually all cancers

  2. only in lymphoma and leukemia

  3. only in experimental animals

  4. only in elderly patients

  5. in immunosuppressed patients


Correct Option: E
Explanation:

Strongly immunogenic tumors appears in immunosuppressed patients. For example, certain types of skin cancer and lymphoma seen in transplant patients receiving immunosuppression.

Which among the following is a coreceptor of HIV?

  1. RANTES

  2. CD8

  3. CD54

  4. CR5

  5. CXCR4


Correct Option: E
Explanation:

CXCR4 is a chemokine receptor which HIV utilizes as a coreceptor for entry into naive CD4+ T-cells and mature dendritic cells. Another chemokine receptor, CCR5, is used particularly for entry of HIV into immature dendritic cells, macrophages and activated effector or memory CD4+ T-cells.

Which among the following statements regarding SCID is false?

  1. Most cases of SCID are due to mutations in the gene encoding the common gamma chain.

  2. The condition is inherited in an X-linked dominant pattern.

  3. The second most common form of SCID is caused by a defective enzyme.

  4. PNP is a key enzyme in the purine salvage pathway.

  5. The most common treatment for SCID is bone marrow transplantation.


Correct Option: B
Explanation:

The common gamma chain is encoded by the gene IL-2 receptor gamma, or IL-2Rγ, which is located on the X-chromosome. For this reason, immunodeficiency caused by mutations in IL-2Rγ is known as X-linked severe combined immunodeficiency. The condition is inherited in an X-linked recessive pattern.

Which of the following HIV antigens provides a potential target for neutralising antibodies produced in the host?

  1. U3

  2. gp120

  3. Reverse transcriptase

  4. Protease

  5. Tat


Correct Option: B
Explanation:

gp120 is an envelope protein which binds to CD4 on the T-cell. Antibodies to the V3 loop of gp120 arise during the disease and are particularly effective as neutralising agents in vitro, although less so in vivo. Generally, neutralising antibodies are more effective against HIV-2 than against HIV-1.

Which of the following is/are not helpful in the diagnosis of AIDS?

  1. CD4 numbers

  2. CD8 numbers

  3. Skin tests to test bacterial antigens

  4. Lymph node biopsy

  5. Serum p24 antigen


Correct Option: B
Explanation:

CD8 numbers are largely unaffected. It is the ratio of CD4:CD8 that falls dramatically.

Which among the following statements doesnot characterises chronic lymphocytic leukemia?

  1. It usually has a very poor prognosis.

  2. It has a good prognosis only in those patients with circulating monoclonal immunoglobulin.

  3. It is mostly a disease of childhood.

  4. It is usually found in people over 50 years of age.

  5. It is a leukemia where both kappa and lambda light chains are found on the surface of the malignant cell.


Correct Option: D
Explanation:

CLL is uncommon in people under 50 years of age.

Secondary immunodeficiencies are acquired and are much more common. Which of the following is/are not linked with secondary immunodeficiency in human beings?

  1. Viral infection

  2. Lymphoproliferative disorders

  3. Cytotoxic drugs

  4. High fat diet

  5. Low iron diet


Correct Option: D
Explanation:

There is no evidence that a high fat diet can lead to secondary immunodeficiency.

Both DNA and RNA viruses have been shown to be capable of causing cancer in humans and thus, are known as oncogenic viruses. Which among the following is an oncovirus?

  1. Herpes zoster

  2. HIV-2

  3. Epstein-Barr virus

  4. Vesicular stomatitis virus

  5. Proteus mirabilis


Correct Option: C
Explanation:

Epstein-Barr virus, human papilloma virus, hepatitis B virus, and human herpes virus-8 are the four DNA viruses that are capable of causing the development of human cancers. Epstein-Barr virus is associated with Burkitt's lymphoma and with naso-pharyngeal carcinoma.

Boon and colleagues showed that syngeneic transplantable tumors, which mutate such that they express strong transplantation antigens, are rejected. What did they call these variants?

  1. Tum –

  2. Xenogeneic

  3. Tum +

  4. MCA

  5. Hapten


Correct Option: A
Explanation:

Tum – cell lines are those which have mutated such that they cannot be grown in syngeneic animals with a normal immune system.

Mr. Verma is suffering from pancreatic carcinoma. In pancreatic carcinoma, the ras gene

  1. is absent

  2. is normal but is overexpressed

  3. has a large deletion

  4. contains a single point mutation, always at the same position

  5. contains a single point mutation, but not always at the same position


Correct Option: E
Explanation:

Point mutation leads to a single amino acid substitution at either position 12, 13 or 61. These mutations are found in over 90% of patients with pancreatic carcinomas, in 40% of patients with colorectal cancers and their preneoplastic lesions, in acute myeloid leukemia (AML) and in preleukemic syndromes.

What is the cause of primary immunodeficiency producing susceptibility to infection by viruses and molds?

  1. B-cell deficiency

  2. T-cell deficiency

  3. Phagocyte deficiency

  4. Complement deficiency

  5. Eosinophil deficiency


Correct Option: B
Explanation:

Production of cytokines and of cytotoxic T-cells are important in the protective response.

Which among the following techniques is utilised in detecting viral nucleic acids?

  1. Viral isolation

  2. Western blot

  3. Polymerase chain reaction (PCR)

  4. ELISA

  5. Viral differential test


Correct Option: C
Explanation:

In case of HIV infection this test finds either the RNA of the HIV virus or the HIV DNA in white blood cells infected with the virus. The PCR test is very useful to find a very recent infection.

Doctor told Aruna that her father is suffering from a disease which occurs due to the deletions in T-cell CD154 (CD40L) gene. Which among the following diseases must the doctor be referring to?

  1. Hyper–IgM syndrome

  2. Congenital X-linked agammaglobulinemia

  3. IgA deficiency

  4. Wiskott–Aldrich syndrome

  5. Deficiency in cytotoxic T-cell activity


Correct Option: A
Explanation:

Lack of CD154 (CD40L) prevents signalling to the B-cell CD40 to bring about Ig class-switching away from IgM.

HLA-DR2 is a risk factor for which among the following diseases?

  1. Multiple sclerosis

  2. Insulin-dependent (type I) diabetes

  3. Breast cancer

  4. Lung cancer

  5. Blood cancer


Correct Option: A
Explanation:

Individuals with HLA-DR2 are more at risk of developing multiple sclerosis than those with other HLA-DR specificities. Thus a higher frequency of HLA-DR2 is found in MS patients versus the normal population.

T-helpers during HIV infection can be bypassed by all of the following, except

  1. failure of regulatory T-cells

  2. polyclonal activation of B-cells

  3. idiotypic mechanisms

  4. antigenic cross-reaction

  5. T-cell recognition of carrier complexed to autoantigen


Correct Option: A
Explanation:

Failure of regulatory T-cells would release the T-helper for direct stimulation by antigen. This statement is therefore incorrect, since this would not be a bypass of the T-helpers.

Autoantigen selection of responding B-cells during tumor formation in the body is indicated by

  1. germ line configuration of the antibody

  2. high affinity antibody

  3. expression of a public idiotype

  4. a monoclonal antibody response

  5. a response to many different autoantigens


Correct Option: B
Explanation:

The mutation of the antibody variable region genes in B-cells in the germinal center produces a range of antibody affinities, and those B-cells bearing higher affinity antibody will be favourably selected for further stimulation by antigen.

Cyclophosphamide is a commonly used drug in anticancer therapy. Which of the following statements is FALSE regarding this drug?

  1. The structure is metabolised to release acrolein.

  2. It cannot be taken orally.

  3. It is comparitively non-toxic.

  4. It acts as a prodrug in the body.

  5. It is mainly used in the treatment of lymphomas.


Correct Option: B
Explanation:

The drug is called cyclophosphamide. It can be taken orally . Since it is a prodrug, it is not toxic to the gut wall when taken orally.

Which among the following molecules is/are involved in the gripping of cells to an extracellular matrix during a tumor progression in an individual?

  1. Cyclins

  2. Interleukins

  3. Angiostatin

  4. Integrins

  5. Kringle domains


Correct Option: D
Explanation:

Integrins are a family of transmembrane glycoprotein receptors that mediate cell-matrix. They are involved in the anchoring of cells to an extracellular matrix. They affect tumour progression has made them an appealing target for cancer therapy.

Which among the following statements does NOT characterise adenomas?

  1. Colons are the most common organs that are affected by adenomas.

  2. Breasts may be affected by fibroadenomas.

  3. The adenomas of adrenal gland are rarely cancerous.

  4. Adenomas of thyroids are present as thyroid nodules.

  5. Large adenomas in kidneys cause paraneoplastic syndromes.


Correct Option: E
Explanation:

Large adenomas in vital hormone producing organs raise the hormones the organ produces leading to serious complications called paraneoplastic syndromes.

Which among the following terms is used to signify the ability of a cancer to invade other body parts of an individual and to produce secondary tumors?

  1. Mutagenesis

  2. Metastasis

  3. Apoptosis

  4. Carcinogenesis

  5. Epigenesis


Correct Option: B
Explanation:

Metastasis refers to the spread of a cancer to different parts of the body and the appearance of secondary tumours.

The growth of new blood vessels in the body is known as

  1. biosynthesis

  2. apoptosis

  3. angiogenesis

  4. metastasis

  5. metagenomics


Correct Option: C
Explanation:

Angiogenesis is the term used to indicate the growth of new blood vessels.It is a normal and vital process in growth and development, as well as in wound healing.

A benign neoplasm derived from glandular epithelial cells is referred to as

  1. papilloma

  2. polyp

  3. carcinoma

  4. adenoma

  5. sarcoid


Correct Option: D
Explanation:

Adenoma is a type of non-cancerous tumor or benign that may affect various organs. It is derived from the word “adeno” meaning 'pertaining to a gland'.Every cell in the body has a tightly regulated system that dictates when it needs to grow, mature and eventually die off. Tumors and cancers occur when cells lose this control and divide and proliferate indiscriminately.

Which among the following is a naturally occurring product being studied as an anticancer agent in humans?

  1. Aclarubicin

  2. Depsipeptide

  3. Fumagillin

  4. Thalidomide

  5. Teclozan


Correct Option: B
Explanation:

Depsipeptide is derived from a bacterial strain and is reduced to an active compound that promotes apoptosis and inhibits cell proliferation and angiogenesis.

The anticancer therapy entangling the administration of an antibody linked to an enzyme is

  1. GDAPT

  2. GDEPT

  3. ADAPT

  4. ADEPT

  5. SIADH


Correct Option: D
Explanation:

ADEPT stands for antibody-directed enzyme prodrug therapy entangling the association of an enzyme to an antibody. It is the use of monoclonal antibodies (or mAb) to specifically bind to target cells or proteins.

Which among the following statements regarding pancreatic cancer is false?

  1. Pancreatic cancer rarely occurs before the age of 40.

  2. Signs and symptoms of the most common form of pancreatic cancer may include yellow skin or back pain.

  3. Neuroendocrine tumors are a diverse group of malignant tumors.

  4. Cigarette smoking is the best established avoidable risk factor for pancreatic cancer.

  5. At least 50% of people with pancreatic adenocarcinoma have diabetes at the time of diagnosis.


Correct Option: C
Explanation:

Neuroendocrine tumors (NETs) are a diverse group of benign and malignant tumors that arise from the body's neuroendocrine cells, which are responsible for integrating the nervous and endocrine systems.

The structural component of HIV required for cell–cell fusion is

  1. p2 protein

  2. p24

  3. gp 41

  4. gp 120

  5. gp 160


Correct Option: C
Explanation:

For the HIV infection to occur the cell fusion is essential. This is done by the transmembrane glycoprotein gp 41. HIV-1 utilizes two major co-receptors along with CD4 to bind to, fuse with, and enter target cells.

Which among the following is an oncoprotein of the Epstein–Barr virus (EBV)?

  1. NSP2

  2. HBx

  3. HBcAg

  4. HBsAg

  5. LMP1


Correct Option: E
Explanation:

LMP1 is the best-documented oncoprotein of the Epstein-Barr virus (EBV), latent gene products.

Which of the following statements regarding human immunodeficiency virus is false?

  1. p32 is an integrase.

  2. p10 is a protease enzyme that breaks gag precursor.

  3. The reverse transcriptase enzyme is a prominent feature of retroviruses.

  4. Ras gene products are involved in kinase signalling pathways.

  5. Gag gene encodes for the lipid bilayer of the virus.


Correct Option: E
Explanation:

The gag gene is encoded as a large gag-pol protein with another gene then cleaved to the precursor protein assemblin, which is then cleaved to Gag. It is involved in virion assembly and produces some of the capsid and nucleocapsid proteins. It does not encodes for the lipid bilayer of the virus.

EBV is the herpes virus that is most strongly associated with cancer. Which among the following diseases is/are not caused by EBV?

  1. X-linked MASA syndrome

  2. Hodgkin's lymphoma

  3. B-cell lymphomas

  4. Nasopharyngeal cancer

  5. Burkitt's lymphoma


Correct Option: A
Explanation:

MASA syndrome, is a rare X-linked recessive neurological disorder. It is caused by mutations in the L1CAM gene.

A doctor told a couple that their son is a patient of plasmablastic lymphoma which is a rare and aggressive variant of diffuse large B-cell lymphoma. Which among the following viruses causes hematologic malignancies in such patients?

  1. Cytomegalovirus

  2. Human herpes virus 5

  3. Human herpes virus 4

  4. Human herpes virus 3

  5. Kaposi's sarcoma herpes virus (HHV-8)


Correct Option: E
Explanation:

HHV-8 infects lymphocytes and epithelial / endothelial cells and is the causative agent of Kaposi's sarcoma. It has also been associated with hematologic malignancies, including primary effusion lymphoma, multicentric Castleman's, MCD-related immunoblastic / plasmablastic lymphoma.

In a virus, the RNA genome covering protein is

  1. G protein

  2. M protein

  3. L protein

  4. N protein

  5. Gag-onc fusion protein


Correct Option: D
Explanation:

This is the major structural protein and covers the RNA genome. It protects the genome from nucleases and holds it in a conformation that allows transcription.

Which of the following is the most common form of Severe Combined Immune Deficiencies (SCIDs)?

  1. Interleukin receptor common gamma chain deficiency

  2. IgA deficiency

  3. IRAK-4 deficiency

  4. RAG1/RAG2 deficiency

  5. Di George syndrome


Correct Option: A
Explanation:

Although an X-linked disease, this is still the SCID with the highest incidence

Which among the following blocks the tyrosine kinase signalling in the host cell?

  1. Vpu

  2. LMP-2A

  3. E2

  4. NSP2

  5. Gp41


Correct Option: B
Explanation:

LMP-2A is a transmembrane protein that act to block tyrosine kinase signaling. It inhibits activation of the viral lytic cycle.

Which of the following is most pertinent to healthy individuals with selective IgA deficiency?

  1. All individuals can be considered to be normal without risk of infections.

  2. They are more likely to develop heart disease than those with normal IgA levels.

  3. They will always have a high risk of HIV infection.

  4. They have a high risk of a recurrent serious bacterial infection.

  5. They have a higher risk of developing an organ specific autoimmune disease or allergies than the general population.


Correct Option: E
Explanation:

Organ-specific autoimmune diseases, are defined as disorders in which the body’s immune response attacks healthy cells in a specific organ.Individuals with selective IgA deficiency have a higher risk of developing an organ specific autoimmune disease or allergies than the general population.

Vaibhav and his brother are HIV-infected. Which among the following fungi are recognised from the oral cavity of HIV-infected patients?

  1. Candida kefyr

  2. Candida glabrata

  3. Candida famata

  4. Candida dubliniensis

  5. Candida albicans


Correct Option: D
Explanation:

Candida dubliniensis has recently been recognised from the oral cavity of HIV-infected patients and are most frequently implicated in cases of recurrent infection following antifungal drug treatment.

People with weakened immune systems are more prone to be infected by

  1. blastomycosis

  2. histoplasmosis

  3. mucormycosis

  4. pneumocystis pneumonia

  5. sporotrichosis


Correct Option: D
Explanation:

Pneumocystis pneumonia is a disease caused by the fungus Pneumocystis jirovecii. It is one of the most frequent and severe opportunistic infections in people with weakened immune systems, particularly people with HIV/AIDS.

An oncovirus is a virus that can cause cancer. Which among the following is the first described oncovirus?

  1. Koala retrovirus

  2. Avian sarcoma leukosis virus

  3. Rous sarcoma virus

  4. Visna virus

  5. Bovine immunodeficiency virus


Correct Option: C
Explanation:

Rous sarcoma virus is a retrovirus and is the first oncovirus to have been described. It causes sarcoma in chickens.

In human beings, AIDS and cancer cause immunosuppression. Such immunosuppressed patients are more susceptible to get infected by

  1. Curvularia

  2. Phaeoannellomyces werneckii

  3. Scedosporium prolificans

  4. Sporothrix schenckii

  5. Wangiella dermatitidis


Correct Option: A
Explanation:

It is a rare cause of subcutaneous, sinusitis, endocarditis, peritonitis and disseminated infection in immunosuppressed patients.

APOBE is a family of evolutionary conserved proteins. Which among the following viral factors disrupts the antiviral activity of this human enzyme?

  1. Vif

  2. Nef

  3. Vpr

  4. Rev

  5. Tat


Correct Option: A
Explanation:

Vif stands for viral infectivity factor. It is a protein found in HIV and other retroviruses. Its role is to disrupt the antiviral activity of the human enzyme APOBEC by targeting it for ubiquitination and cellular degradation.

Which of the following clinical features is NOT usually associated with HIV infection?

  1. A glandular fever-like illness

  2. Persistent generalised lymphadenopathy

  3. Gonococcal septicaemia

  4. Slim disease

  5. Presenile dementia


Correct Option: C
Explanation:

Unusual in HIV (except at a late stage when any infection is possible); more often associated with complement deficiencies

Which of the following is/are a proven route of transmission of HIV?

  1. Swimming pools

  2. Mosquitoes

  3. Shared bathroom facilities

  4. Semen

  5. Bed bugs


Correct Option: D
Explanation:

HIV is transmitted through certain body fluids that are capable of containing high concentrations of HIV antibodies, such as blood and semen.

By which of the following ways can HIV not be contracted?

  1. Sharing needles

  2. Sexual intercourse

  3. Sharing toothbrushes

  4. Breast feeding

  5. Via the placenta


Correct Option: C
Explanation:

This has been proven not to transmit HIV but is not recommended on general health grounds!.

Most cases of acute leukaemia in children are of which of the following types?

  1. T-cell ALL

  2. Mature B-cell ALL

  3. Hairy cell leukaemia

  4. Pre-B-cell ALL

  5. Histiocytic leukaemia


Correct Option: D
Explanation:

64% of ALL are the pre-B cell type. The commonest ALL in children is the pre-B cell ALL.

A doctor told Mrs. Verma that her newborn is suffering from Severe Combined Immune Deficiency (SCID). Which of the following findings is the most common indicator in an infant with SCID?

  1. Lymphopenia

  2. Severe asthma

  3. Dry skin

  4. Pneumonia

  5. Staphylococcal abscess


Correct Option: A
Explanation:

Almost all infants with SCID have reduced lymphocyte counts. Remember that infants have a higher lymphocyte count range than adults by 3.5-fold.

Which of the following statements about IgA deficiency is FALSE?

  1. IgA deficiency is defined as a blood level < 0.07 g/l.

  2. IgA deficiency is the most common of the primary immune deficiencies.

  3. Many patients with IgA deficiency are healthy throughout their lives.

  4. Patients with IgA deficiency may suffer from an increased prevalence of allergies.

  5. There is a defined problem with the class switch mechanisms for IgG in such patients.


Correct Option: E
Explanation:

There is no known problem with the class switch mechanisms for IgG in most IgA deficient patients (as yet) but a small proportion, usually those who present with infections, have poor responses to either carbohydrate or protein antigens +/- low IgG subclass levels. There is linkage with MHC class II and class III genes but almost certainly this is not the whole story; the precise mechanisms are not known.

Which of the following statements about complications in AIDS patients is incorrect?

  1. Tuberculosis is a major cause of death in Africa.

  2. Candida infection of the oesophagus is a feature observed in such patients.

  3. After the diagnosis of AIDS is made, the average survival time has been estimated around 10 years.

  4. Malabsorption is common in such patients.

  5. Human herpes virus type 8 (HHV 8) results in malignancy.


Correct Option: C
Explanation:

After the diagnosis of AIDS is made, the average survival time has been estimated to be 2-3 years.

Chronic lymphocytic leukaemia (CLL) is a type of slow growing blood cancer that affects developing B-lymphocytes. Chronic lymphocytic leukaemia is commonly associated with which of the following features?

  1. Invariably rapid demise

  2. Slow but progressive course

  3. Overwhelming bleeding

  4. Hepatitis

  5. Thymoma


Correct Option: B
Explanation:

Patients are usually over 50 years of ageand the life expectancy is 15 years, depending on the stage of disease at presentation.

Chronic granulomatous disease is a disorder that causes the immune system to malfunction, resulting in a form of immunodeficiency. Which of the following is the primary defect in chronic granulomatous disease (CGD)?

  1. Neutrophil production in the bone marrow

  2. Neutrophil chemotaxis

  3. Neutrophil intracellular killing of organisms

  4. Opsonisation

  5. Cytotoxic T-cell activity


Correct Option: C
Explanation:

Neutrophils from patients with CGD fail to produce super-oxide that enables an influx of potassium ions to activate the intracellular enzymes that kill organisms.

Which of the following is most pertinent to common variable immune deficiency disorders?

  1. They are always present before the age of 10 years.

  2. They are caused due to a single gene defect on the X chromosome.

  3. They affect 1 in 500 of the population.

  4. Patients are treated by replacement immunoglobulin, intravenously or subcutaneously.

  5. Most patients die from complications of malignancy.


Correct Option: D
Explanation:

Replacement immunoglobulin therapy is also used in CD40 ligand deficiency. Ig is prepared from the plasma collected from a large number of normal individuals, usually between 10,000-50,000, who have been carefully screened to make sure they are healthy and do not harbor certain infectious diseases. The plasma contains a broad range of specific antibodies to many different types of bacteria and viruses.

Epstein-Barr virus was the first virus to be directly associated with human cancer. Epstein-Barr virus is NOT implicated in which of the following conditions?

  1. Infectious mononucleosis

  2. Nasopharyngeal carcinoma

  3. Chronic lymphatic leukaemia

  4. Burkitt's lymphoma

  5. Post-transplantation lymphoproliferative syndrome


Correct Option: C
Explanation:

This is not thought to be due to an infection, but a relatively benign form of leukaemia in the elderly.

Which of the following is commonly associated with marked secondary antibody deficiency in humans?

  1. Mild protein-energy malnutrition

  2. Multiple myeloma

  3. Non-Hodgkin's lymphoma (NHL)

  4. HIV infection

  5. Hodgkin's disease


Correct Option: B
Explanation:

Immune suppression of other, non-paraprotein Ig isotypes is a diagnostic feature.

Which type of leukaemia is most likely to have skin involvement?

  1. Acute leukaemia

  2. Hairy cell leukaemia

  3. Plasma cell leukaemia

  4. Chronic lymphocytic leukaemia (common type)

  5. Sezary syndrome


Correct Option: E
Explanation:

A form of T cell lymphoma with a characteristic dermatitis in a high proportion of patients.

Which of the following microorganisms does NOT use antigenic variation as a major means of evading host defences?

  1. HIV

  2. Streptococcus pneumoniae

  3. Influenza A virus

  4. Borrelia recurrentis

  5. Trypanosoma


Correct Option: B
Explanation:

There are at least 93 serotypes in the world, though 23 prevalent serotypes that cause disease in different parts of the world, but no switching of the bacterium between serotypes. Infections with these organisms are common and often infect those with antibody or innate or combined deficiencies

The Bence-Jones protein urine test is used mainly to diagnose and monitor multiple myeloma, a blood cancer. Bence-Jones proteins are

  1. fragments of transferrin

  2. polyclonal free light chains

  3. monoclonal free light chains

  4. beta 2-microglobulins

  5. prostaglandins


Correct Option: C
Explanation:

Dr Bence Jones originally described proteins that precipitated on heating urine and then disappeared on further heating (unlike albumin which remained in the precipitate). This property turned out to be that of free light chains. Monoclonal free light chains are only seen when there are large amounts of light chain in the urine i.e. in lymphoid (usually plasma cell) malignancy.

The human immunodeficiency virus (HIV) interacts with which of the following cell-surface molecules to gain entry into cells of the immune system?

  1. CD4

  2. CD19

  3. CD40 ligand

  4. CD8

  5. CD25


Correct Option: A
Explanation:

This is a major portal of entry, though not the only one. The chemokine receptors CXCR4 and CCR5 are also major portals of entry and reduce the CD4 positive helper T cell numbers dramatically (see Case 3.11 Acquired immune deficiency syndrome: Kaposi's sarcoma

IgE levels appear to be a very discriminative marker between patients in late stages of HIV infection. Which of the following types of cells produce IgE?

  1. Mast cells

  2. Eosinophils

  3. Basophils

  4. T lymphocytes

  5. Plasma cells


Correct Option: E
Explanation:

Produce immunoglobulins of all isotypes including IgE.

The HIV virus attacks T-helper cells, knocking out the body's ability to defend itself against infections. Helper CD4+ T lymphocytes recognise which of the following types of molecules on dendritic cells?

  1. HLA class I antigen

  2. HLA class III antigen

  3. Processed peptides from antigen

  4. CD8 antigen

  5. Surface immunoglobulin


Correct Option: C
Explanation:

But only if the T cell has the correct antigen specificity in the TCR AND the same HLA class II antigens.

Which of the following statements relating to anti-TNF monoclonal antibody therapies is FALSE?

  1. The risk of latent TB is assessed routinely in immunosuppressed patients by interferon release assays on whole blood.

  2. Clinical characteristics of TB in the setting of anti-TNF therapy include a preponderance of extra-pulmonary disease and poor granuloma formation on histology.

  3. Therapeutic TNF inhibition is associated with significant risk of reactivation of Mycobacterium tuberculosis.

  4. Infliximab is a soluble TNF receptor.

  5. The success of TNF blockade in rheumatoid arthritis (RA) underlines the pivotal proinflammatory role of TNF in this disease.


Correct Option: D
Explanation:

Etanercept is the soluble TNF receptor. Infliximab is a monoclonal antibody - as indicated in the last part of the name InflixiMAB. TNF blockade can be achieved by either the use of a chimeric anti-TNF antibody (infliximab, adalimumab) or a soluble TNF receptor (etanercept).

Many types of human cancer are associated with extensive eosinophilia, either within the tumor itself, or in the peripheral blood, or in both locations. Which of the following cytokines acts as a chemo-attractant for eosinophils?

  1. IL-5

  2. IL-10

  3. IFN-gamma

  4. IL-2

  5. IL-7


Correct Option: A
Explanation:

Part of the pathway involved in IgE production, as well as involved in Th2 cellular responses.

Which of the following agents is NOT immunosuppressive?

  1. Levamisole

  2. Corticosteroid

  3. Thalidomide

  4. Aspirin

  5. Total lymphoid irradiation


Correct Option: D
Explanation:

This is an anti-inflammatory drug. Aspirin is part of a group of medications called non-steroidal anti-inflammatory drugs (NSAIDs) and has antipyretic, anti-inflammatory and analgesic properties but does not affect immunity. Aspirin inhibits the enzyme, cyclooxygenase.

Waldenström's macroglobulinaemia patients often subsequently develop

  1. meningitis

  2. duodenal ulcer

  3. hyperviscosity syndrome

  4. non-Hodgkin's lymphoma

  5. multiple myeloma


Correct Option: C
Explanation:

High levels of serum IgM (a large pentameric protein) make the plasma hyperviscous and this presents with headache, visual disturbances, nose bleeds, malaise or exertional dyspnoea.

Which of the following drugs is used for the treatment of HIV/AIDS infection?

  1. Artesunate

  2. Zanamivir

  3. Zidovudine

  4. Taxol

  5. Levodopa


Correct Option: C
Explanation:

Zidovudine or azidothymidine (AZT) is a type of antiretroviral drug used for the treatment of HIV/AIDS infection.

Which of the following investigations is essential for the diagnosis of all solid B-cell tumors?

  1. Gene rearrangement study

  2. Detection of a thymoma

  3. Bone marrow/lymph node examination

  4. Analysis of urine for protein

  5. X-ray of the skull


Correct Option: C
Explanation:

The diagnosis of all circulating B cell tumours relies on the involvement of the bone marrow. However for solid tumours, such as Hodgkin's disease and Non-Hodgkin's lymphoma, a lymph node biopsy is the essential investigation, though bone marrow trephine is often done to assess stage

CD4+ cells are dominant cells that are an indispensible part of human immune system. Which among the following are NOT CD4+ cells?

  1. Macrophages

  2. T-cytotoxic cells

  3. T-helper cells

  4. Monocytes

  5. Dendritic cells


Correct Option: B
Explanation:

These cells are the vital part of the cellular immune response, destroying the cells which bears any foreign antigen on their surface, mainly virus-infected cells.

A 50 years old Europian has breast cancer. Which of the following genes is most likely to show mutation if genetic testing is done?

  1. BRCA1

  2. BRCA2

  3. PTEN

  4. MIRN21

  5. TMEM49


Correct Option: B
Explanation:

The BRCA2 mutation is the most likely to be associated with male breast cancer.

Which immune marker is observable during the window period of HIV infection?

  1. Antigen p17

  2. Antibodies to gp 41

  3. Antibodies to gp 120

  4. p24 antigen

  5. GSK-3


Correct Option: E
Explanation:

Glycogen synthase kinase 3 is a serine/threonine protein kinase that mediates the addition of phosphate molecules onto serine and threonine amino acid residues.

Which among the following is/are regarded as the best treatment for HIV infection?

  1. Highly active antiretroviral therapy (HAART)

  2. Integrase inhibitors

  3. Protease inhibitors

  4. Reverse transcriptase inhibitors

  5. Telomerase reverse transcriptase


Correct Option: A
Explanation:

HAART is used to suppress HIV viral replication and the progression of HIV disease. It conjoins three or more different drugs such as two nucleoside reverse transcriptase inhibitors (NRTIs) and a protease inhibitor. These HAART regimens have proven to reduce the amount of active virus and in many cases.

Pol refers to a gene in retroviruses. The pol gene does NOT encode for

  1. RNA polymerase

  2. integrase

  3. reverse transcriptase

  4. proteases

  5. trimer


Correct Option: A
Explanation:

This enzyme is involved in the production of RNA from DNA through transcription. It adds ribonucleotides to growing RNA transcripts at the 3’ end. The pol gene does not encode for NA polymerase.

Which among the following genes activates viral gene expression?

  1. gag

  2. rev

  3. nif

  4. tat

  5. nef


Correct Option: D
Explanation:

This gene from human immunodeficiency virus type 1 activates viral gene expression and is essential for HIV replication.

Which among the following accessory regulatory proteins of HIV is neccesary for the successful release of virions from infected cells?

  1. env

  2. pol

  3. gag

  4. vpu

  5. tev


Correct Option: D
Explanation:

Vpu is specific to HIV-1. It is a class I oligomeric integral membrane phosphoprotein with numerous biological functions. Vpu is involved in CD4 degradation involving the ubiquitin proteasome pathway as well as in the successful release of virions from infected cells.

Which among the following techniques is utilised in detecting viral nucleic acids?

  1. Viral isolation

  2. Western blot

  3. Polymerase chain reaction (PCR)

  4. ELISA

  5. Measuring HIV-RNA


Correct Option: C
Explanation:

In case of HIVinfection this test finds either the RNA of the HIV virus or the HIV DNA in white blood cells infected with the virus. The PCR test is very useful to find a very recent infection.

In which among the following stages of AIDS proposed by WHO is the CD4 count less than 350/µl?

  1. Primary HIV infection

  2. Stage I

  3. Stage II

  4. Stage III


Correct Option: D
Explanation:

Advanced symptoms which may include unexplained chronic diarrhea for longer than a month, severe bacterial infections including tuberculosis of the lung, and a CD4 count of less than 350/µl.

World AIDS Vaccine Day is observed annually on

  1. 1st December

  2. 18th May

  3. 25th April

  4. 5th June

  5. 7th April


Correct Option: B
Explanation:

World AIDS Vaccine Day, also known as HIV Vaccine Awareness Day, is observed annually on May 18. HIV vaccine advocates mark the day by promoting the continued urgent need for a vaccine to prevent HIV infection and AIDS.

Which among the following statements does NOT characterise telomerase reverse transcriptase enzyme?

  1. The hTERT gene has become a main focus for gene therapy involving cancer.

  2. Plasmid DNA sequences can be manufactured using the hTERT promoter.

  3. hTERT immortalises various normal cells in culture.

  4. The hTERT gene, located on chromosome 5, consists of 16 exons and 15 introns spanning 35 kb.

  5. Telomere deficiency is associated with cancers and tumor formation.


Correct Option: E
Explanation:

Telomere deficiency is often linked to aging, cancers and the conditions dyskeratosis congenita (DKC) and Cri du chat. Meanwhile, over-expression of hTERT is often associated with cancers and tumor formation.

Which of the following is not a rapid test for the diagnosis of HIV infection in humans?

  1. HIV spot and comb test

  2. Western blotting

  3. Particle agglutination test

  4. Dot blot assay

  5. Wet blot assay


Correct Option: B
Explanation:

It is not a rapid test for the diagnosis of HIV infection. Western blots are considered as the benchmark, and seropositivity is diagnosed when antibodies against both the env and the gag proteins are detected.

Which of the following statements is INCORRECT regarding cancer in humans?

  1. A tumor in a cell is not considered as malignant until it spreads to other parts of the body forming secondary tumors.

  2. A cancer is caused by agglomeration of a small number of mutations, each of which boosts the cell with a growth advantage.

  3. A cancer is a genetic disease frequently being inherited.

  4. Cancer is regarded a disease of old age.

  5. Cancers are a large family of diseases.


Correct Option: C
Explanation:

Cancer is regarded as a genetic disease because it is caused by mutations in the genome. However, these mutations are normally in somatic cells not germ cells and mutations contributing to cancer are rarely inherited. To form a malignant cancer a cell must acquire a small number of mutations (probably about six) each of which gives the cell a growth or survival advantage.

A doctor explained to a couple that their son is suffering from a cancer which derives from epithelial cells of the body. Which among the following cancers must the doctor be referring to?

  1. Blastoma

  2. Germ cell tumor

  3. Lymphoma and leukemia

  4. Sarcoma

  5. Carcinoma


Correct Option: E
Explanation:

Cancers derived from epithelial cells. This group includes many of the most common cancers, particularly in the aged, and include nearly all those developing in the breast, prostate, lung, pancreas, and colon.

Which among the following statements characterises an oncogene?

  1. It codes for a cell cycle control protein in a cell.

  2. It codes for a protein which restricts the cell from apoptosis.

  3. It codes for a mutated form of a protein which creates fractions of a signal transduction pathway.

  4. Many cancer drugs target the proteins encoded by oncogenes.

  5. It is a predominantly expressed mutation providing a cell a growth or survival advantage.


Correct Option: E
Explanation:

An oncogene is a mutated form of a normal cellular gene (the proto-oncogene) which codes for a protein which is either controlled abnormally so that it is expressed in abnormally large amounts or has gained activity so that it is more active than the normal protein.

The protein coded by a tumor suppressor gene in humans is

  1. a protein which controls progression through the cell cycle

  2. a protein which helps prevent apoptosis

  3. a protein which codes for a DNA repair enzyme

  4. a protein which forms fractions of a growth factor signalling pathway

  5. a protein which acts by opposing the action of PI3K


Correct Option: A
Explanation:

Tumour suppressor genes code for proteins which normally control progression through a cell cycle checkpoint. These genes only contribute to a cancer when both copies are mutated in a way which produces an inactive protein product. A single mutation inactivating one gene only has no effect. They contribute to cancer because the absence of the protein product removes controls on cell division.

Which among the following oncogenes forms the death-inducing signalling complex in humans?

  1. pVHL

  2. APC

  3. Fas

  4. YPEL3

  5. ST14


Correct Option: C
Explanation:

Fas forms the death-inducing signaling complex (DISC) upon ligand binding. Membrane-anchored Fas ligand trimer on the surface of an adjacent cell causes oligomerization of Fas.

Sezary syndrome patients often subsequently develop

  1. meningitis

  2. duodenal ulcer

  3. gangrene of the toes

  4. non-Hodgkin's lymphoma

  5. multiple myeloma


Correct Option: D
Explanation:

The non-Hodgkin lymphomas (NHLs) are diverse group of blood cancers that include any kind of lymphoma except Hodgkin's lymphomas. Types of NHL vary significantly in their severity, from slow growing to very aggressive. Since this is a T cell malignancy T cell NHL may follow.

Which among the following statements regarding benign tumors is false?

  1. Benign tumors cause mass effect.

  2. A benign tumor metastasises quickly.

  3. Tumors of endocrine tissues may overproduce certain hormones.

  4. Benign skin tumors are usually surgically ressected.

  5. Benign tumors are mostly well-differentiated.


Correct Option: B
Explanation:

A benign tumor is a mass of cells (tumor) that lacks the ability to invade neighboring tissue or metastasize. These characteristics are required for a tumor to be defined as cancerous and therefore benign tumors are non-cancerous.

In which of the following tumors does the architecture of the tissue get cluttered?

  1. Hamartomas

  2. Lipoma

  3. Adenomas

  4. Chondroma

  5. Teratomas


Correct Option: A
Explanation:

Hamartomas are a group of benign tumors that have relatively normal cellular differentiation but the architecture of the tissue is disorganised.

A heterogeneous group of high-grade carcinomas is referred to as

  1. small cell carcinoma

  2. large cell carcinoma

  3. anaplastic carcinoma

  4. squamous cell carcinoma

  5. adenosquamous carcinoma


Correct Option: C
Explanation:

Refers to a heterogeneous group of high-grade carcinomas that feature cells lacking distinct histological or cytological evidence of any of the more specifically differentiated neoplasms. These tumors are referred to as anaplastic or undifferentiated carcinomas.

Which among the following statements does NOT characterise HIV viral antigen?

  1. Serum antibodies form the first layer of protection of the host from viral infection.

  2. Recombinant viral proteins are expressed in bacteria, yeast, mammalian cells, etc.

  3. Recombinant viral protein usually contains a fusion protein.

  4. Recombinant viral antigens contain part of viral sequence.

  5. ELISAs provide a valuable tool in the detection and diagnosis of viral infection.


Correct Option: A
Explanation:

Antibody-based immune responses form a first layer of protection of the host from viral infection; however, in many cases a vigorous cellular immune response mediated by T-cells and NK-cells is required for effective viral clearance. When cellular immunity is unable to clear the virus, the infection can become chronic, and serum antibodies to the viral pathogen are used as first indicator for the diagnosis of the disease.

Human immunodeficiency virus (HIV), the cause of AIDS, belongs to the category of

  1. single-stranded DNA (ssDNA)

  2. reverse-transcribing viruses

  3. double-stranded RNA (dsRNA)

  4. negative sense single-stranded RNA (ssRNA-)

  5. positive sense single-stranded RNA (ssRNA+)


Correct Option: B
Explanation:

These have dsDNA or ssRNA genomes and their replication includes the synthesis of DNA from RNA by the enzyme reverse transcriptase; many integrate into their host genomes. The group includes the retroviruses, of which Human immunodeficiency virus (HIV), the cause of AIDS, is a member. There is a single family of plant viruses in this group and this is characterised by a single component of circular dsDNA, the replication of which is via an RNA intermediate.

Response of non-small cell lung cancer to gefitinib is predicted by mutation in

  1. EGF receptor gene

  2. ABL1 proto-oncogene

  3. Myc oncogene

  4. PAG1

  5. Cbl


Correct Option: A
Explanation:

EGFR is a cell surface protein that binds to epidermal growth factor. Binding of the protein to a ligand induces receptor dimerization and tyrosine autophosphorylation and leads to cell proliferation. Mutations in this gene are associated with lung cancer. Multiple alternatively spliced transcript variants that encode different protein isoforms have been found for this gene.

The whole genome of which of the following viruses is translated in a polyprotein?

  1. Ebolavirus

  2. Flavivirus

  3. Tobacco mosaic virus

  4. T4 bacteriophage

  5. Human immunodeficiency virus


Correct Option: B
Explanation:

The virion RNA is infectious and serves as both the genome and the viral messenger RNA. The whole genome is translated in a polyprotein, which is processed co- and post-translationally by host and viral proteases.

A division of the circular single stranded viruses has been proposed for easy and convenient study. Which among the following types of genomes is characterised by small circular DNA genome?

  1. Type I genomes

  2. Type II genomes

  3. Type III genomes

  4. Type IV genomes

  5. Type V genomes


Correct Option: A
Explanation:

Type I genomes are characterized by a small circular DNA genome (approximately 2-kb), with the Rep protein and the major open reading frame (ORF) in opposite orientations. This type is characteristic of the circoviruses, geminiviruses and nanoviruses.

Oncogenesis is the process by which normal cells are transformed into cancer cells. Which among the following viruses may have a hit and run mechanism of oncogenesis?

  1. Papillomavirus

  2. Polyomavirus

  3. Simian virus 40

  4. Adenovirus

  5. Herpesvirus


Correct Option: E
Explanation:

Herpesvirus are much larger than the DNA viruses having a genome size of 100 to 200 kilobases. These are often co-carcinogens. They may have a hit and run mechanism of oncogenesis.

Who among the following scientists discovered the human immunodeficiency virus (HIV) and developed the HIV blood test?

  1. Benjamin Rubin

  2. Jonas Edward Salk

  3. Gallo

  4. Edward Jenner

  5. Wortley Montague


Correct Option: C
Explanation:

Robert Charles Gallo is an American biomedical researcher. He is best known for his role in the discovery of the human immunodeficiency virus (HIV) as the infectious agent responsible for acquired immune deficiency syndrome (AIDS) and in the development of the HIV blood test, and he has been a major contributor to subsequent HIV research.

Protective antibodies formed in the body against viral agents are known as

  1. non-specific antibodies

  2. natural killers

  3. toxoids

  4. neutralising antibodies

  5. autoantibodies


Correct Option: D
Explanation:

A Neutralizing antibody is an antibody which defends a cell from an antigen or infectious body by inhibiting or neutralizing any effect it has biologically. An example of a neutralizing antibody is HIV antitoxin, which can neutralize the biological effects of HIV.

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