2026 Clinical Immunology Course Pre-Test

Unless otherwise stated, please answer each question to the best of your ability.

Question Title

1. A 24-year-old woman develops generalized urticaria, wheezing, and hypotension within minutes of eating shrimp at a restaurant. Which immunologic mechanism is primarily responsible for her symptoms? (Required.)

Immune complex deposition

IgE-mediated mast cell degranulation

T-cell mediated cytotoxicity

Complement deficiency

IgG-mediated hemolysis

Question Title

2. A 7-year-old boy has recurrent sneezing, nasal congestion, and itchy eyes every spring. Skin prick testing is positive for tree pollen. Which cell type is most responsible for the late-phase allergic response? (Required.)

Neutrophils

Basophils

Eosinophils

Platelets

B lymphocytes

Question Title

3. A 19-year-old college student experiences lip swelling, throat tightness, and dizziness after eating a cookie containing peanuts. After intramuscular epinephrine is administered, what is the next best step? (Required.)

Immediate discharge home

Observation for biphasic reaction

Administration of oral antibiotics

Skin biopsy

High-dose aspirin therapy

Question Title

4. A child with moderate atopic dermatitis has severe itching and recurrent skin infections. Which immune abnormality is commonly associated with atopic dermatitis? (Required.)

Th1 predominance

Reduced mast cells

Th2-skewed immune response

Complement overactivation

Excess regulatory T cells

Question Title

5. A child presents with early-onset autoimmune cytopenias, enteropathy, and recurrent infections. Genetic testing is unrevealing. Which of the following best explains why additional immune testing is useful? (Required.)

Most immune dysregulation disorders are caused by infections

Functional immune abnormalities may identify dysregulated pathways even without a molecular diagnosis

Genetic testing excludes immune dysregulation disorders

Immune phenotyping replaces the need for clinical evaluation

Question Title

6. A patient develops recurrent sinopulmonary infections several months after CD19 CAR-T therapy. Which immune abnormality is most likely contributing to this complication? (Required.)

Complement deficiency

T-cell lymphopenia alone

Persistent B-cell aplasia with hypogammaglobulinemia

Neutrophilia

Question Title

7. Which of the following is true regarding the complement cascade? (Required.)

The complement system is primarily activated by eosinophils and mast cells

The complement system can only be activated by IgG-containing immune complexes

Complement activation is tightly controlled by several different endogenous regulatory proteins

Complement proteins are predominantly produced within the spleen and bone marrow

Question Title

8. The complement system helps to protect the host from which of the following diseases? (2 answers) (Required.)

Cardiovascular disease

Bacterial infections

Autoimmunity

Diabetes Mellitus

Question Title

9. Which of the following is true regarding complement inhibitory drugs? (Required.)

Studies have shown that complement inhibitory drugs significantly reduce mortality in patients with sepsis

Complement inhibitory drugs should always be used in combination with glucocorticoids

More than 10 different complement inhibitory drugs have been approved by the U.S. Food and Drug Administration

Therapeutic complement inhibitors are only effective in patients with high titers of autoantibodies

Question Title

10. Phase 1 Clinical Trials: (Required.)

Allow to determine the dosage of a drug to be tested further in Phase 2 clinical trials.

Are performed if possible on healthy subjects.

Are performed after market authorization.

Are based on Bayesian statistics.

Are usually retrospective case studies.

Question Title

11. Phase 3 clinical trials: (Required.)

Mainly aim to evaluate the efficacy of drugs for rare diseases.

Are primarily designed to monitor safety.

Are performed to obtain market authorization.

Are performed on terminally ill patients.

Should not include secondary endpoints.

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12. What factors influence the immune response elicited by vaccination? (Required.)

Question Title

13. How do booster doses affect the magnitude and quality of both cellular and humoral immune responses? (Required.)

Question Title

14. What mechanisms underlie immune cross-reactivity against variants of concern? (Required.)

Question Title

15. Which components of the vaccine-induced immune response are most affected by the emergence of variants of concern? (Required.)

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16. Why is it important to assess both antibody responses and T cell responses in vaccine clinical trials? (Required.)

Question Title

17. What are the differences in immune responses induced by homologous versus heterologous vaccination strategies? (Required.)

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18. Which of the following best describes the role of PD-L1 expressed on tumor cells? (Required.)

It activates CD8+ T cells to mount a stronger anti-tumor response.

It binds PD-1 on T cells, delivering an inhibitory signal that suppresses T cell activity.

It recruits natural killer (NK) cells to the tumor microenvironment.

It upregulates MHC-I expression, making tumor cells more visible to the immune system.

Question Title

19. A bone marrow biopsy from a newly diagnosed AML patient shows leukemic blasts with markedly reduced MHC-I surface expression and high CD47 levels. Which of the following best explains how these findings help the leukemia evade immune destruction? (Required.)

A bone marrow biopsy from a newly diagnosed AML patient shows leukemic blasts with markedly reduced MHC-I surface expression and high CD47 levels. Which of the following best explains how these findings help the leukemia evade immune destruction?

High CD47 promotes antigen presentation on dendritic cells, accelerating T cell priming against AML blasts.

Low MHC-I renders blasts invisible to CD8+ T cells, while high CD47 signals macrophages to spare the cells — disabling both adaptive and innate immune arms simultaneously.

Reduced MHC-I triggers NK cell-mediated killing, which fully compensates for the loss of CD8+ T cell recognition.

Question Title

20. A patient with relapsed AML is found to have CD8+ T cells co-expressing PD-1, TIM-3, LAG-3, and TIGIT. Which of the following best describes the functional state of these T cells and its clinical implication? (Required.)

The T cells are fully activated and predict a durable response to chemotherapy.

The T cells are terminally exhausted, with impaired cytokine production and reduced anti-leukemia activity — correlating with increased relapse risk.

The T cells are in a memory state, primed for rapid re-expansion upon antigen re-exposure.

Co-expression of these receptors indicates successful immune surveillance and tumor clearance.

Question Title

21. Induction therapy in transplantation primarily: (Required.)

Is identical across all organs

Varies by organ

Is never used in solid organ transplant

Is only used in bone marrow transplant

Question Title

22. Which of the following are commonly used in the setting of solid organ transplantation (check all that apply): (Required.)

Tacrolimus

Imlifidase

Prednisone

Etanercept

All of the above

Question Title

* 1. A 24-year-old woman develops generalized urticaria, wheezing, and hypotension within minutes of eating shrimp at a restaurant. Which immunologic mechanism is primarily responsible for her symptoms? (Required.)

Question Title

* 2. A 7-year-old boy has recurrent sneezing, nasal congestion, and itchy eyes every spring. Skin prick testing is positive for tree pollen. Which cell type is most responsible for the late-phase allergic response? (Required.)

Question Title

* 3. A 19-year-old college student experiences lip swelling, throat tightness, and dizziness after eating a cookie containing peanuts. After intramuscular epinephrine is administered, what is the next best step? (Required.)

Question Title

* 4. A child with moderate atopic dermatitis has severe itching and recurrent skin infections. Which immune abnormality is commonly associated with atopic dermatitis? (Required.)

Question Title

* 5. A child presents with early-onset autoimmune cytopenias, enteropathy, and recurrent infections. Genetic testing is unrevealing. Which of the following best explains why additional immune testing is useful? (Required.)

Question Title

* 6. A patient develops recurrent sinopulmonary infections several months after CD19 CAR-T therapy. Which immune abnormality is most likely contributing to this complication? (Required.)

Question Title

* 7. Which of the following is true regarding the complement cascade? (Required.)

Question Title

* 8. The complement system helps to protect the host from which of the following diseases? (2 answers) (Required.)

Question Title

* 9. Which of the following is true regarding complement inhibitory drugs? (Required.)

Question Title

* 10. Phase 1 Clinical Trials: (Required.)

Question Title

* 11. Phase 3 clinical trials: (Required.)

Question Title

* 12. What factors influence the immune response elicited by vaccination? (Required.)

Question Title

* 13. How do booster doses affect the magnitude and quality of both cellular and humoral immune responses? (Required.)

Question Title

* 14. What mechanisms underlie immune cross-reactivity against variants of concern? (Required.)

Question Title

* 15. Which components of the vaccine-induced immune response are most affected by the emergence of variants of concern? (Required.)

Question Title

* 16. Why is it important to assess both antibody responses and T cell responses in vaccine clinical trials? (Required.)

Question Title

* 17. What are the differences in immune responses induced by homologous versus heterologous vaccination strategies? (Required.)

Question Title

* 18. Which of the following best describes the role of PD-L1 expressed on tumor cells? (Required.)

Question Title

* 19. A bone marrow biopsy from a newly diagnosed AML patient shows leukemic blasts with markedly reduced MHC-I surface expression and high CD47 levels. Which of the following best explains how these findings help the leukemia evade immune destruction? (Required.)

Question Title

* 20. A patient with relapsed AML is found to have CD8+ T cells co-expressing PD-1, TIM-3, LAG-3, and TIGIT. Which of the following best describes the functional state of these T cells and its clinical implication? (Required.)

Question Title

* 21. Induction therapy in transplantation primarily: (Required.)

Question Title

* 22. Which of the following are commonly used in the setting of solid organ transplantation (check all that apply): (Required.)

1. A 24-year-old woman develops generalized urticaria, wheezing, and hypotension within minutes of eating shrimp at a restaurant. Which immunologic mechanism is primarily responsible for her symptoms? (Required.)

2. A 7-year-old boy has recurrent sneezing, nasal congestion, and itchy eyes every spring. Skin prick testing is positive for tree pollen. Which cell type is most responsible for the late-phase allergic response? (Required.)

3. A 19-year-old college student experiences lip swelling, throat tightness, and dizziness after eating a cookie containing peanuts. After intramuscular epinephrine is administered, what is the next best step? (Required.)

4. A child with moderate atopic dermatitis has severe itching and recurrent skin infections. Which immune abnormality is commonly associated with atopic dermatitis? (Required.)

5. A child presents with early-onset autoimmune cytopenias, enteropathy, and recurrent infections. Genetic testing is unrevealing. Which of the following best explains why additional immune testing is useful? (Required.)

6. A patient develops recurrent sinopulmonary infections several months after CD19 CAR-T therapy. Which immune abnormality is most likely contributing to this complication? (Required.)

7. Which of the following is true regarding the complement cascade? (Required.)

8. The complement system helps to protect the host from which of the following diseases? (2 answers) (Required.)

9. Which of the following is true regarding complement inhibitory drugs? (Required.)

10. Phase 1 Clinical Trials: (Required.)

11. Phase 3 clinical trials: (Required.)

12. What factors influence the immune response elicited by vaccination? (Required.)

13. How do booster doses affect the magnitude and quality of both cellular and humoral immune responses? (Required.)

14. What mechanisms underlie immune cross-reactivity against variants of concern? (Required.)

15. Which components of the vaccine-induced immune response are most affected by the emergence of variants of concern? (Required.)

16. Why is it important to assess both antibody responses and T cell responses in vaccine clinical trials? (Required.)

17. What are the differences in immune responses induced by homologous versus heterologous vaccination strategies? (Required.)

18. Which of the following best describes the role of PD-L1 expressed on tumor cells? (Required.)

19. A bone marrow biopsy from a newly diagnosed AML patient shows leukemic blasts with markedly reduced MHC-I surface expression and high CD47 levels. Which of the following best explains how these findings help the leukemia evade immune destruction? (Required.)

20. A patient with relapsed AML is found to have CD8+ T cells co-expressing PD-1, TIM-3, LAG-3, and TIGIT. Which of the following best describes the functional state of these T cells and its clinical implication? (Required.)

21. Induction therapy in transplantation primarily: (Required.)

22. Which of the following are commonly used in the setting of solid organ transplantation (check all that apply): (Required.)