Introduction:
This quiz collection on Immunopharmacology: mediators of inflammation and immune response is tailored for M.Pharm students preparing for advanced pharmacology exams. The 20 MCQs focus on key inflammatory mediators (histamine, prostaglandins, leukotrienes, cytokines, complement, bradykinin, nitric oxide, reactive oxygen species, platelet-activating factor), their receptors, biosynthetic enzymes, pathophysiological roles, and pharmacologic modulation (NSAIDs, glucocorticoids, leukotriene modifiers, biologics, complement and kinin antagonists). Questions emphasize mechanism-based understanding, drug targets, and clinical relevance to help deepen conceptual knowledge and improve application skills for therapeutics and exam success.
Q1. Which mediator is primarily responsible for immediate (type I) hypersensitivity symptoms such as itching, vasodilation and bronchoconstriction?
- Prostaglandin E2
- Histamine
- Leukotriene B4
- Bradykinin
Correct Answer: Histamine
Q2. Which cyclooxygenase isoform is predominantly inducible during inflammation and a major source of proinflammatory prostaglandins?
- COX-1
- COX-2
- COX-3
- Thromboxane synthase
Correct Answer: COX-2
Q3. Glucocorticoids exert part of their anti-inflammatory effect by inducing synthesis of which protein that inhibits phospholipase A2?
- Annexin-1 (lipocortin)
- Cyclooxygenase-2
- 5-Lipoxygenase
- Complement factor H
Correct Answer: Annexin-1 (lipocortin)
Q4. Which leukotriene is the most potent chemoattractant for neutrophils and contributes to leukocyte recruitment in inflammation?
- LTC4
- LTD4
- LTB4
- LTE4
Correct Answer: LTB4
Q5. Which drug directly inhibits 5-lipoxygenase and thereby reduces leukotriene synthesis?
- Montelukast
- Zileuton
- Indomethacin
- Prednisone
Correct Answer: Zileuton
Q6. Montelukast produces its therapeutic effect in asthma by which mechanism?
- Inhibition of 5-lipoxygenase enzyme
- Antagonism of CysLT1 receptors
- Stimulation of β2-adrenergic receptors
- Inhibition of phosphodiesterase
Correct Answer: Antagonism of CysLT1 receptors
Q7. Bradykinin mediates which of the following classic inflammatory symptoms?
- Bronchoconstriction without pain
- Vasoconstriction and reduced permeability
- Pain and increased vascular permeability
- Neutrophil chemotaxis only
Correct Answer: Pain and increased vascular permeability
Q8. Which complement fragment is the most potent chemoattractant for neutrophils?
- C3a
- C3b
- C5a
- C4a
Correct Answer: C5a
Q9. Which therapeutic agent is a monoclonal antibody that inhibits cleavage of complement component C5 and is used in complement-mediated disorders?
- Eculizumab
- Infliximab
- Etanercept
Correct Answer: Eculizumab
Q10. Which anti-TNF agent is a fusion protein consisting of the extracellular domain of the TNF receptor linked to the Fc portion of IgG?
- Infliximab
- Adalimumab
- Etanercept
- Certolizumab
Correct Answer: Etanercept
Q11. Anakinra produces anti-inflammatory effects by which mechanism?
- Neutralizing TNF-α
- Blocking IL-1 receptors
- Inhibiting IL-6 synthesis
- Antagonizing IL-17
Correct Answer: Blocking IL-1 receptors
Q12. Which nitric oxide synthase isoform is inducible in macrophages and mediates cytotoxic and microbicidal activity during inflammation?
- eNOS (NOS3)
- nNOS (NOS1)
- iNOS (NOS2)
- mtNOS
Correct Answer: iNOS (NOS2)
Q13. A defect in which enzyme complex underlies chronic granulomatous disease leading to impaired respiratory burst in neutrophils?
- NADPH oxidase
- Myeloperoxidase
- Superoxide dismutase
- Catalase
Correct Answer: NADPH oxidase
Q14. Selective COX-2 inhibitors (coxibs) increase the risk of thrombosis primarily because they reduce production of which protective mediator in endothelium?
- Thromboxane A2
- Prostaglandin I2 (prostacyclin)
- Leukotriene B4
- Bradykinin
Correct Answer: Prostaglandin I2 (prostacyclin)
Q15. Low-dose aspirin exerts an antiplatelet effect mainly by irreversibly inhibiting platelet synthesis of which mediator?
- Prostaglandin E2
- Thromboxane A2
- Prostacyclin (PGI2)
- Leukotriene C4
Correct Answer: Thromboxane A2
Q16. The anti-inflammatory action of systemic glucocorticoids includes suppression of which inducible enzyme involved in prostaglandin synthesis?
- Cyclooxygenase-1
- Cyclooxygenase-2
- Thromboxane synthase
- 5-Lipoxygenase
Correct Answer: Cyclooxygenase-2
Q17. Which prostaglandin is most closely associated with mediating fever and sensitizing peripheral nerves to pain?
- PGD2
- PGE2
- PGF2α
- PGI2 (prostacyclin)
Correct Answer: PGE2
Q18. Icatibant is a pharmacologic antagonist used to treat hereditary angioedema by blocking which receptor?
- Bradykinin B2 receptor
- Histamine H1 receptor
- CysLT1 receptor
- IL-6 receptor
Correct Answer: Bradykinin B2 receptor
Q19. Activation of the classical complement pathway is initiated when C1q binds to which of the following?
- Mannose on microbial surfaces
- IgM or IgG immune complexes
- Properdin
- Lipopolysaccharide
Correct Answer: IgM or IgG immune complexes
Q20. Chemokines of the CXC family that contain an ELR motif (Glu-Leu-Arg) are particularly potent at recruiting which cell type and promoting angiogenesis?
- Lymphocytes
- Monocytes
- Neutrophils
- Eosinophils
Correct Answer: Neutrophils
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