Immunopharmacology – introduction and scope MCQs With Answer

Immunopharmacology – introduction and scope MCQs With Answer
Immunopharmacology explores how drugs interact with the immune system, covering immunomodulators, immunosuppressants, vaccines, monoclonal antibodies, cytokine therapies, and adverse effects. For B.Pharm students this field links pharmacodynamics, pharmacokinetics, mechanism of action, therapeutic monitoring, and immunotoxicology. Key topics include innate and adaptive immunity, hypersensitivity, biologics, checkpoint inhibitors, CAR-T, vaccine adjuvants, and biosimilars. Understanding drug‑immune system interactions helps optimize therapy for autoimmune disease, transplant rejection, infection, and cancer while minimizing immunogenicity and infections. This concise, application‑oriented view builds foundation for clinical use and drug development. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. What does immunopharmacology primarily study?

• Interactions between drugs and the immune system, and drug effects on immune responses
• Only the chemistry of vaccine adjuvants
• Pharmacokinetics of antibiotics unrelated to immunity
• Only genetic causes of immunodeficiency

Correct Answer: Interactions between drugs and the immune system, and drug effects on immune responses

Q2. Which cell type is the principal mediator of humoral immunity?

• Natural killer (NK) cells
• Neutrophils
• B lymphocytes
• Macrophages

Correct Answer: B lymphocytes

Q3. MHC class I molecules present antigenic peptides to which T cell subset?

• CD4+ T helper cells
• Regulatory T cells
• CD8+ cytotoxic T lymphocytes
• B cells

Correct Answer: CD8+ cytotoxic T lymphocytes

Q4. Which interaction provides the crucial co‑stimulatory signal (signal 2) for naïve T cell activation?

• TCR binding to peptide‑MHC only
• CD28 on T cell binding to B7 (CD80/86) on APC
• IgE crosslinking on mast cells
• Fc receptor binding to immune complexes

Correct Answer: CD28 on T cell binding to B7 (CD80/86) on APC

Q5. Which cytokine is most important for driving Th1 differentiation and cell‑mediated immunity?

• Interleukin‑4 (IL‑4)
• Interleukin‑10 (IL‑10)
• Interleukin‑12 (IL‑12)
• Interleukin‑5 (IL‑5)

Correct Answer: Interleukin‑12 (IL‑12)

Q6. Cyclosporine exerts immunosuppressive effects primarily by inhibiting which target?

• mTOR complex
• Calcineurin phosphatase
• Dihydrofolate reductase
• Janus kinases (JAKs)

Correct Answer: Calcineurin phosphatase

Q7. Sirolimus (rapamycin) suppresses immune responses by inhibiting which pathway?

• mTOR signaling pathway
• Calcineurin activation
• NF‑kB nuclear translocation
• Tyrosine kinase BCR‑ABL

Correct Answer: mTOR signaling pathway

Q8. Low‑dose methotrexate used as a DMARD has immunomodulatory effects primarily through:

• Direct B cell depletion by CD20 binding
• Inhibition of dihydrofolate reductase and increased extracellular adenosine
• Blocking TNF‑alpha receptor
• Inhibition of calcineurin

Correct Answer: Inhibition of dihydrofolate reductase and increased extracellular adenosine

Q9. Infliximab is classified as which type of biologic agent?

• Small‑molecule TNF inhibitor
• Chimeric monoclonal antibody against TNF‑alpha
• Human recombinant cytokine
• Checkpoint inhibitor targeting PD‑1

Correct Answer: Chimeric monoclonal antibody against TNF‑alpha

Q10. Ipilimumab, used in cancer immunotherapy, blocks which immune checkpoint?

• PD‑1
• CTLA‑4
• CD28
• IL‑6 receptor

Correct Answer: CTLA‑4

Q11. CAR‑T cell therapies for B cell malignancies typically target which antigen?

• HER2
• CD19
• EGFR
• PD‑L1

Correct Answer: CD19

Q12. The classical complement pathway is primarily activated by:

• Pattern recognition by mannose‑binding lectin
• Spontaneous C3 hydrolysis
• Antigen‑antibody (immune) complexes
• Toll‑like receptor signaling

Correct Answer: Antigen‑antibody (immune) complexes

Q13. Vaccine adjuvants enhance immune responses mainly by:

• Directly neutralizing pathogens
• Promoting antigen uptake and activating innate immune receptors on APCs
• Blocking MHC presentation
• Suppressing cytokine release

Correct Answer: Promoting antigen uptake and activating innate immune receptors on APCs

Q14. Live attenuated vaccines are generally contraindicated in:

• Healthy adults
• Pregnant women and severely immunosuppressed patients
• People with controlled asthma
• Patients on topical antibiotics

Correct Answer: Pregnant women and severely immunosuppressed patients

Q15. Filgrastim (G‑CSF) is used clinically to treat which condition?

• Thrombocytopenia
• Neutropenia following chemotherapy
• Aplastic anemia due to T cell infiltration
• Autoimmune hemolytic anemia

Correct Answer: Neutropenia following chemotherapy

Q16. The development of anti‑drug antibodies (ADAs) against biologics primarily leads to:

• Enhanced therapeutic efficacy
• Neutralization of the biologic and loss of response or hypersensitivity
• Improved pharmacokinetics via increased half‑life
• Increased oral bioavailability

Correct Answer: Neutralization of the biologic and loss of response or hypersensitivity

Q17. Type I hypersensitivity reactions are mediated by which antibody and cell type?

• IgG and macrophages
• IgE and mast cells/basophils
• IgM and neutrophils
• IgA and epithelial cells

Correct Answer: IgE and mast cells/basophils

Q18. Which drug is well known to cause severe agranulocytosis as a rare adverse effect?

• Acetaminophen
• Clozapine
• Metformin
• Hydrochlorothiazide

Correct Answer: Clozapine

Q19. Glucocorticoids suppress immune responses mainly by:

• Enhancing IL‑2 production
• Inhibiting NF‑kB and transcription of proinflammatory cytokines
• Activating mTOR signaling in T cells
• Upregulating MHC class II expression

Correct Answer: Inhibiting NF‑kB and transcription of proinflammatory cytokines

Q20. A major infectious risk associated with anti‑TNF therapy is reactivation of which latent infection?

• Hepatitis A
• Tuberculosis
• Malaria
• Giardiasis

Correct Answer: Tuberculosis

Q21. Interleukin‑2 (IL‑2) therapy is used clinically to stimulate which cell population for cancer therapy?

• B cells producing high‑affinity antibodies
• CD8+ T cells and NK cells to enhance antitumor activity
• Neutrophils for bacterial clearance
• Eosinophils for parasitic infections

Correct Answer: CD8+ T cells and NK cells to enhance antitumor activity

Q22. Rituximab depletes which cell population by targeting which antigen?

• T cells by targeting CD3
• B cells by targeting CD20
• Plasma cells by targeting CD138
• Monocytes by targeting CD14

Correct Answer: B cells by targeting CD20

Q23. Antibody‑dependent cellular cytotoxicity (ADCC) is mediated primarily through which antibody region interacting with effector cells?

• Fab region binding antigen only
• Fc region binding Fc gamma receptors on NK cells
• Hinge region blocking complement
• Light chain variable region triggering apoptosis

Correct Answer: Fc region binding Fc gamma receptors on NK cells

Q24. A biosimilar biologic is best described as:

• An identical chemical copy of a small‑molecule drug
• A highly similar version of an approved biologic with no clinically meaningful differences
• A generic produced by simple chemical synthesis
• An unrelated compound with the same brand name

Correct Answer: A highly similar version of an approved biologic with no clinically meaningful differences

Q25. PD‑1 inhibitors (e.g., pembrolizumab) enhance antitumor immunity by:

• Delivering cytotoxic payloads to tumor cells
• Blocking inhibitory PD‑1 signaling on T cells to restore activity
• Inhibiting IL‑2 production by T cells
• Stimulating regulatory T cell expansion

Correct Answer: Blocking inhibitory PD‑1 signaling on T cells to restore activity

Q26. Type II hypersensitivity reactions are primarily characterized by:

• Immune complex deposition in vessel walls
• Cell‑bound antibody causing complement‑mediated cytotoxicity
• IgE‑mediated mast cell degranulation
• Delayed T cell‑mediated skin reactions only

Correct Answer: Cell‑bound antibody causing complement‑mediated cytotoxicity

Q27. Before starting azathioprine, clinicians often test for deficiency of which enzyme to predict toxicity?

• CYP2D6
• Thiopurine methyltransferase (TPMT)
• Glucose‑6‑phosphate dehydrogenase (G6PD)
• N-acetyltransferase (NAT2)

Correct Answer: Thiopurine methyltransferase (TPMT)

Q28. Imiquimod, used as a topical immunomodulator, acts primarily as an agonist of which receptor?

• Toll‑like receptor 7 (TLR7)
• Interleukin‑1 receptor
• Complement receptor 3
• Fc epsilon receptor

Correct Answer: Toll‑like receptor 7 (TLR7)

Q29. Hepatitis B vaccines based on the recombinant surface antigen are examples of which vaccine type?

• Live attenuated vaccines
• Subunit (recombinant) vaccines
• Conjugate vaccines using toxoids
• Inactivated whole‑cell vaccines

Correct Answer: Subunit (recombinant) vaccines

Q30. The neonatal Fc receptor (FcRn) influences pharmacokinetics of therapeutic IgG by:

• Transporting IgG into lysosomes for rapid degradation
• Recycling IgG back to circulation, prolonging its half‑life
• Blocking Fc gamma receptor binding on effector cells
• Enhancing renal excretion of IgG fragments

Correct Answer: Recycling IgG back to circulation, prolonging its half‑life

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