SGrade/USMLE Step 1/Immunology (Advanced)
Immunology (Advanced) Practice Questions
Types I–IV hypersensitivity, rejection and immunosuppressants, primary immunodeficiencies, complement pathways, ANCA vasculitides, and checkpoint inhibitors.
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A 25-year-old woman develops an intensely pruritic, erythematous, and vesicular rash on her wrist 48 hours after wearing a new nickel bracelet. The rash is localized to the area of contact. Which of the following immune mechanisms is primarily responsible for this reaction?
Examiner's Design Intent
The NBME designed this question to assess a student's ability to differentiate between the four types of hypersensitivity reactions, specifically focusing on the classic clinical presentation (timing, morphology, trigger…
A 32-year-old man presents to the emergency department after being stung by a bee. Within minutes, he develops widespread urticaria, facial swelling, severe dyspnea, and hypotension. He is treated with epinephrine and antihistamines. The immediate clinical manifestations in this patient are primarily due to the rapid release of inflammatory mediators following activation of which of the following?
Examiner's Design Intent
The NBME designed this question to assess a student's foundational understanding of Type I hypersensitivity (anaphylaxis), specifically the ability to link a classic acute clinical presentation ('within minutes' onset of…
A 3-year-old girl is brought to the pediatrician due to a history of recurrent bacterial infections, including multiple episodes of otitis media, pneumonia, and cellulitis, often caused by encapsulated bacteria such as Streptococcus pneumoniae and Haemophilus influenzae. Her family history is notable for consanguinity. A thorough workup reveals normal immunoglobulin levels and normal lymphocyte counts. A defect in which of the following complement components would most likely explain her susceptibility to these recurrent infections?
Examiner's Design Intent
The NBME designed this question to assess a student's ability to correlate specific clinical presentations (recurrent encapsulated bacterial infections, normal Ig/lymphocytes) with a precise underlying basic science mech…
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