1. When would the concentration of HIV particles in the bloodstream of an HIV infected person be lowest?
(a) During the “acute phase” or “window period” before the person tests positive for HIV antibodies
(b) During the “latent phase” when there are no symptoms of AIDS
(c) During the time when the person is suffering from ARC (AIDS Related Complex)
(d) During the time when the person is suffering from “full-blown” AIDS
(e) It depends on the individual when the viral titer will be lowest

2. A single HIV gene, pol, codes for a single large (inactive) protein that is then cut into pieces to yield active reverse transcriptase, protease, and integrase. What is responsible for this cutting?
(a) Core proteins
(b) Reverse Transcriptase
(c) Protease
(d) Integrase
(e) gp120

3. A B-cell will be stimulated to divide rapidly and clonally if
(a) It interacts with an antigen that it recognizes
(b) It interacts with an antigen-presenting dendritic cell that recognizes the same antigen as the B-cell
(c) It interacts with an antigen-presenting macrophage that recognizes the same antigen as the B-cell
(d) It presents an antigen to a T-helper cell that recognizes the same antigen as the B-cell
(e) It presents an antigen to a dendritic cell that recognizes the same antigen as the B-cell

4. Who was Selma Dritz?
(a) A co-worker of Robert Gallo and the one who actually developed the procedure for growing retroviruses in culture
(b) A public health worker for the city of San Francisco
(c) A technician at the CDC who noticed an excessive number of unexplained orders for pentamidine (used to treat pneumocystis pneumonia)
(d) The woman who became mayor of San Francisco when George Moscone was assasinated
(e) A Danish physician who worked in Africa and became one of the first Europeans to die of AIDS

5. “Antigen presentation” means that a foreign body has been englufed by a cell, partially digested, and pieces of it are attached to a molecule that appears on the surface of the cell. The molecule that “presents” the antigen is
(a) CD4
(b) gp102
(c) T-cell receptor
(d) Antibody
(e) MHC (“self”)

6. Francoise Barrre, Willy Rozenbaum, Luc Montagnier, and Jacques Leibowitch are all associated with the AIDS crisis in the 1980’s, What else do they have in common?
(a) They all lived in France
(b) They were all elected officials
(c) They were all AIDS patients
(d) They were all gay men who did NOT have AIDS
(e) They were all employed by the CDC

7. The ultimate fate of a fully mature B-cell is
(a) To kill other cells
(b) To activate macrophages and other B-cells
(c) To produce antibodies and shed them into the bloodstream
(d) To transport antigens to the lymph nodes
(e) To direct all the other cells of the immune system to divide or not

8. Which of these is the smallest?
(a) Reverse transcriptase
(b) HIV
(c) Salmonella typhi
(d) T-helper cell
(e) Macrophage

9. Pictures of HIV taken with an electron microscope show that it is an enveloped virus with an inner core that is shaped like a
(a) Thread
(b) Comma
(c) Regular icosahedron
(d) Cone
(e) Sphere

10. In May of 1983, Stanford University Medical Center became the first major center to test donated blood for signs of AIDS, using a machine to measure the ratio of T-helper cells to total T-cells. As a result
(a) Other blood banks opposed Stanford’s action as pandering and “selling fear”
(b) There was a flood of requests for federal funding of cell-sorting machines, which the Reagan administration refused in almost every case
(c) Other centers praised Stanford and suggested that this was the right thing to do because San Francisco was the AIDS capital of the US — but that it would be a waste of money in other parts of the US
(d) There was a wave of lawsuits against Stanford because earlier blood donations were not screened and were the source of any AIDS cases
(e) Stanford was forced to close its medical center.

11. Which of these is true of HIV-infected infants
(a) In general, they progress to AIDS more slowly than HIV-infected adults
(b) In general, they progress to AIDS more quickly than HIV-infected adults
(c) In general, they progress to AIDS at about the same rate as HIV-infected adults
(d) They never progress to AIDS because of maternal antibodies
(e) There are no HIV-infected infants because infants do not express CCR5 on their cells

12. When an HIV particle infects a T-helper cell,
(a) First gp120 attaches to CD4, then gp41 attaches to CCR5, then the membranes fuse
(b) First gp41 attaches to CD4, then gp120 attaches to CCR5, then the membranes fuse
(c) First gp120 attaches to CD4, then gp120 attaches to CCR5, then gp41 attaches to the membrane of the T-helper cell
(d) First gp41 attaches to CD4, then gp41 attaches to CCR5, then gp120 attaches to the membrane of the T-helper cell
(e) First HIV uses its CD4 molecule to attach to a MHC (“self”) molecule, then it uses its specific antigen receptor to test whether the “self” molecule carries the right antigen, then the HIV is pulled into the cell

13. Why don’t your T-helper cells recognize your own cells and tissues?
(a) If they did, they would have committed suicide early in their development (this is the answer that was suggested by the notes and lecture so this answer is counted as correct on this exam)
(b) If they did, the B-cells and macrophages would recognize them first and kill them (B-cells cannot do this, but macrophages and other phagocytes can, so this question is also counted as correct)
(c) If they did, the interaction of complement with the antibodies made by the T-cell would lead to death of the T-cell
(d) They do but most of those events are quite harmless
(e) They do, but your body keeps the T-helper cells sequestered in the lymph nodes where they will not come in contact with any other of your cells

14. According to Randy Shilts’ book, which of these groups isolated the virus that came to be known as HIV first?
(a) The French
(b) The Americans
(c) The Belgians
(d) The Danish
(e) The Japanese

15. The cell that tells all the other cells of the immune system what to do is
(a) B-cell
(b) Macrophage
(c) Dendritic cell
(d) Phagocyte
(e) T-helper cell

16. Of the following diseases, how many are caused by viruses?
HIV/AIDS, Smallpox, Influenza, Genital Herpes
(a) none
(b) one
(c) two
(d) three
(e) all four

17. The activation of a T-helper cell in response to a presented antigen requires two specific interactions. These are
(a) gp120 with CD4 and gp120 with CCR5 (or CXCR4 in some cases)
(b) antibody with CD4 and CD4 with T-cell receptor
(c) CD4 with MHC (“self”) and T-cell receptor with MHC (“self”)
(d) MHC (“self”) with antibody and CD4 with T-cell receptor
(e) gp120 with MHC (“self”) and gp120 with CCR5 (or CXCR4 in some cases)

18. In testimony before Congress during 1982 and the first half of 1983, the administrators of the Dept. of Health and Human Services
(a) Opposed the Reagan administration’s claims that there was sufficient money for AIDS because they knew that more money was urgently needed
(b) Opposed the Reagan administration’s claims that there was sufficient money for AIDS to gain political advantage by supporting the requests of gays and hemophiliacs, important voting blocs
(c) Supported the Reagan administration’s claims that there was sufficient money for AIDS even though they knew that more money was urgently needed
(d) Supported the Reagan administration’s claims that there was sufficient money for AIDS because they were unaware of the scientists’ urgent needs for more money
(e) Played no role as they were never asked to appear before any congressional committee

19. The highest concentration of T-helper cells is likely to be found
(a) In the blood
(b) In muscle tissue
(c) In nerves, brain, and spinal cord
(d) In the lymph nodes
(e) In the mucous membranes

20. When would the concentration of CD4+ T-helper cells in the bloodstream of an (untreated) HIV-infected person be lowest?
(a) During the “acute phase” or “window period” before the person tests positive for HIV antibodies
(b) During the “latent phase” when there are no symptoms of AIDS
(c) During the time when the person is suffering from ARC (AIDS Related Complex)
(d) During the time when the person is suffering from “full-blown” AIDS
(e) It depends on the individual when the T-helper cell titer will be lowest

21. Which of these would you expect to find in an HIV-infected individual during the “window period” before the person tests positive for HIV antibodies?
(a) Pneumocystis carinii pneumonia
(b) Night sweats
(c) Recurrent shingles
(d) Thrush
(e) Swollen glands

22. Although Robert Gallo was convinced that the AIDS virus was a member of the HTLV family, Luc Montagnier was convinced that it was not because
(a) HTLV kills lymphocytes whereas the AIDS virus makes them reproduce out of control
(b) The AIDS virus kills lymphocytes whereas HTLV makes them reproduce out of control
(c) The AIDS virus has reverse transcriptase whereas HTLV does not
(d) HTLV has reverse transcriptase whereas the AIDS virus does not
(e) HTLV originated in Japan and the French were convinced that AIDS originated in Africa

23. The principal role of a dendritic cell is
(a) To kill other cells
(b) To activate macrophages and other B-cells
(c) To produce antibodies and shed them into the bloodstream
(d) To transport antigens to the lymph nodes
(e) To direct all the other cells of the immune system to divide or not