IMMUNOLOGY & SEROLOGY PROGRESS EXAM

Serologic HLA testing uses a form of complement- dependent microlymphocytotoxicity (CDC) performed in 60-well or 72-well microtiter trays. Trays are usually read on:

a. Brightfield microscopes

b. Darkfield microscopes

c. Polarizing microscopes

d. Inverted phase contrast microscopes

d

In the production of hybridoma, plasma cells are harvested from:

a. Rabbit kidney

b. Rabbit spleen

c. Mouse liver

d. Mouse spleen

d

In fluorescent antinuclear antibody testing, _______ or human epithelial HEp-2 cells are fixed to a slide and allowed to react with patient serum.

a.Rabbit kidney

b. Rabbit spleen

c. Mouse kidney

d. Mouse spleen

d

Which receptor on T cells is responsible for rosetting with sheep red blood cells?

a.CD2

b. CD3

c. CD4

d. CD8

a

Carrier particles to which antigens are attached in Streptozyme testing:

a. Bentonite

b. Charcoal

c. Horse RBCs

d. Sheep RBCs

d

Marginal B cells remain in the:

a. Bone marrow

b. Lymph nodes

c. Spleen

d. Peyer's patches

c

Primary antibody found in Helicobacter pylori infection:

a. IgA

b. IgD

c. IgG

d. IgM

c

Mantoux tuberculin test:*

a. Type I hypersensitivity reaction

b. Type II hypersensitivity reaction

c. Type III hypersensitivity reaction

d. Type IV hypersensitivity reaction

d

The process by which cells are capable of moving from the circulating blood to the tissues by squeezing through the wall of a blood vessel:

a. Chemotaxis

b. Diapedesis

c. Endosmosis

d. Phagocytosis

b

The migration of cells in the direction of a chemical messenger:

a. Chemotaxis

b. Diapedesis

c. Endosmosis

d. Phagocytosis

a

In plasma, it is associated with HDL cholesterol, and it is thought to play a role in metabolism of cholesterol:

a. Alpha1-antitrypsin

b. Fibrinogen

c. Mannose-binding lectin

d. Serum amyloid A

d

Serum amyloid A has been found to increase significantly more in:*

a. Bacterial infections

b. Fungal infections

c. Parasitic infections

d. Viral infections

a

Cells that express CD56 and/or CD16:*

a. B cells

b. T cells

c. NK cells

d. All of the above

c

For serum VDRL, the slide is rotated at:*

a. 100 rpm for 4 minutes

b. 100 rpm for 8 minutes

c. 180 rpm for 4 minutes

d. 180 rpm for 6 minute

c

For RPR, the card is rotated at:*

a. 100 rpm for 4 minutes

b. 100 rpm for 8 minutes

c. 180 rpm for 4 minutes

d. 180 rpm for 8 minutes

b

Most heat-labile of all immunoglobulins:

a. IgA

b. IgD

c. IgE

d. IgM

c

IgE has the ability to activate:*

a. B cells

b. B cells and T cells

c. Basophils and mast cells

d. Eosinophils and neutrophils

c

IgE recruits _____________ to the area to help destroy invading antigens that have penetrated IgA defenses:*

a. B cells

b. B cells and T cells

c. Basophils and mast cells

d. Eosinophils and neutrophils

d

The classical complement pathway is activated by:*

a. Most viruses

b. Antigen-antibody complexes

c. Fungal cell walls

d. All of the above

b

Triggering substances for the alternative pathway:*

a. Antigen-antibody complex

b. Bacterial cell walls, especially those containing lipopolysaccharide; fungal cell walls; yeast; viruses; virally infected cells; tumor cell lines; and some parasites, especially trypanosomes

c. Microorganisms with mannose or similar sugars in their cell wall

d. All of the above

b

Mannose-binding protein in the lectin pathway is most similar to which classical pathway component?

a. C3b

b. C1rs

c. C1q

d. C4

c

An antigen that triggers a type I hypersensitivity response:*

a. Hapten

b. Histamine

c. Allergen

d. Oncogene

c

Cytokines produced by T cells and other cell lines that inhibit viral synthesis or act as immune regulators:*

a. Integrins

b. Interferons

c. Complement

d. Antibodies

b

Decreased maternal alpha fetoprotein levels are associated with:*

a. Anencephaly

b. Down syndrome

c. Twins or multiple pregnancies

d. Spina bifida

b

Positive rheumatoid factor is generally associated with:*

a. Anemia

b. Azotemia

c. Decreased ESR

d. Hyperglobulinemia

d

Skin pH keeps most microorganisms from growing:*

a. 5.6

b. 6.5

c. 7.2

d. 8.0

a

Antigen in the RPR test:*

a. Anti-cardiolipin

b. Cardiolipin

c. Charcoal

d. Reagin

b

Microscope used for the Quantitative Buffy Coat (QBC) method for diagnosis of malaria:*

a. Darkfield microscope

b. Fluorescent microscope

c. Phase contrast microscope

d. Polarizing microscope

b

Color of the AHG reagent:*

a. Red

b. Yellow

c. Blue

d. Green

d

Anticoagulant for the direct AHG test (DAT):*

a. ACD

b. EDTA

c. Heparin

d. Oxalate

b

Present in 70% of patients with lupus and are highly specific for the disease:*

a. Anti-DNP

b. Anti-RNP

c. Anti-dsDNA

d. Anti-CCP

c

T in TORCH or STORCH stands for:*

a. Trichinellosis

b. Trichuriasis

c. Toxoplasmosis

d. None of the above

c

In the chain of infection, a contaminated work area would serve as which of the following:*

a. Source

b. Method of transmission

c. Host

d. All of the above

a

In the process of phagocytosis, formation of hypochlorite and hydroxyl ions damage _______ irreversibly.*

a. DNA

b. RNA

c. Carbohydrates

d. Proteins

d

Which tumor marker is used to monitor patients with breast cancer for recurrence of disease?*

a. CA 15-3

b. Estrogen receptor (ER)

c. Cathepsin-D

d. CA 50

a

Antinuclear antibodies (ANA) include:*

a. Abs to DNA

b. Abs to DNA, abs to nucleolar antigens

c. Abs to DNA, abs to nucleolar antigens and abs to histone

d. Abs to DNA, abs to nucleolar antigens, abs to histone and abs to nonhistone proteins

d

All are components of the second line of defense, except:*

a. Macrophages

b. Mast cells

c. Neutrophils

d. B cells

d

A vacuole formed within a phagocytic cell as pseudopodia surround a particle during the process of phagocytosis:*

a. Neutrophil

b. Monocyte

c. Phagosome

d. Phagolysosome

c

The structure formed by the fusion of cytoplasmic granules and the phagocytic vacuole during the process of phagocytosis:

a. Neutrophil

b. Monocyte

c. Phagosome

d. Phagolysosome

d

It has been used to treat hepatitis C and Kaposi's sarcoma, as well as certain leukemias and lymphomas:*

a. TGF-alpha

b. TGF-beta

c. IFN-alpha

d. IFN-beta

c

Efficacious in treating multiple sclerosis, although the exact mechanism of action remains unclear:*

a. TGF-alpha

b. TGF-beta

c. IFN-alpha

d. IFN-beta

d

A single ASO titer is considered to be moderately elevated if the titer is at least ______ Todd units in an adult:*

a. 160

b. 200

c. 240

d. 320

c

A single ASO titer is considered to be moderately elevated if the titer is at least ______ Todd units in a child.*

a. 160

b. 200

c. 240

d. 320

d

Antibodies to which of the following viral antigens are usually the first to be detected in HIV infection?*

a. gp120

b. gp160

c. gp41

d. p24

d

Most sensitive and reliable; reference method for VZV antibody:*

a. Latex agglutination

b. ELISA

c. FAMA

d. PCR

c

The most commonly used method to detect VZV antibodies in the clinical laboratory:*

a. Latex agglutination

b. ELISA

c. FAMA

d. PCR

b

Most common cause of congenital infections:*

a. Cytomegalovirus

b. Rubella

c. Syphilis

d. Toxoplasmosis

a

Prenatal congenital toxoplasmosis can be diagnosed by performing ______ on amniotic fluid to detect T. gondii DNA.*

a. EIA

b. IFA

c. FAMA

d. PCR

d

Method of choice for diagnosis of congenital toxoplasmosis:*

a. EIA

b. IFA

c. FAMA

d. PCR

a

Method of choice to detect T. gondii DNA in CSF:*

a. EIA

b. IFA

c. FAMA

d. PCR

d

The cells that Metchnikoff first observed are associated with which phenomenon?*

a. Innate immunity

b. Adaptive immunity

c. Humoral immunity

d. Specific immunity

a

Which of the following statements is true of NK cells?*

a. They rely upon memory for antigen recognition.

b. They have the same CD groups as B cells.

c. They are found mainly in lymph nodes.

d. They kill target cells without prior exposure to them.

d

Which cell is the most potent phagocytic cell in the tissue?

a. Neutrophil

b. Dendritic cell

c. Eosinophil

d. Basophil

b

A cell characterized by a nucleus with two to five lobes, a diameter of 10 to 15 μm, and a large number of neutral staining granules is identified as a(n):

a. Eosinophil

b. Monocyte

c. Basophil

d. Neutrophil

d

Where do lymphocytes mainly come in contact with antigens?*

a. Secondary lymphoid organs

b. Bloodstream

c. Bone marrow

d. Thymus

a

hich of the following statements best characterizes adaptive immunity?*

a. Relies on normally present body functions

b. Response is similar for each exposure

c. Specificity for each individual pathogen

d. Involves only cellular immunity

c

The main function of T cells in the immune response is to:*

a. Produce cytokines that regulate both innate and adaptive immunity

b. Produce antibodies

c. Participate actively in phagocytosis

d. Respond to target cells without prior exposure

a

Antigenic groups identified by different sets of antibodies reacting in a similar manner to certain standard cell lines best describes:*

a. Cytokines

b. Clusters of differentiation (CD)

c. Neutrophilic granules

d. Opsonins

b

All of the following are characteristics of an effective immunogen except:*

a. Internal complexity

b. Large molecular weight

c. Presence of numerous epitopes

d. Found on host cells

d

HLA molecules A, B, and C belong to which MHC class?*

a. Class I

b. Class II

c. Class III

d. Class IV

a

Which best explains the difference between immunogens and antigens?*

a. Only antigens are large enough to be recognized by T cells

b. Only immunogens can react with antibody

c. Only immunogens can trigger an immune response

d. Only antigens are recognized as foreign.

c

The term for enhancement of phagocytosis by coating of foreign particles with serum proteins is*

a. Opsonization

b. Agglutination

c. Solubilization

d. Chemotaxis

a

How do cytotoxic T cells kill target cells?*

a. They produce antibodies that bind to the cell.

b. They engulf the cell by phagocytosis.

c. They stop protein synthesis in the target cell.

d. They produce granzymes that stimulate apoptosis.

d

Which is a distinguishing feature of a pre-B cell?*

a. μ chains in the cytoplasm

b. Complete IgM on the surface

c. Presence of CD21 antigen

d. Presence of CD25 antigen

a

Where does the major portion of antibody production occur?*

a. Peripheral blood

b. Bone marrow

c. Thymus

d. Lymph node

d

A cell flow cytometry pattern belonging to a 3-year old patient showed the following: normal CD4+ T-cell count, normal CD19+ B-cell count, low CD8+ T-cell count. Which type of immunity would be affected?*

a. Production of antibody

b. Formation of plasma cells

c. Elimination of virally infected cells

d. Downregulation of the immune response

c

Which of the following is a unique characteristic of adaptive immunity?*

Ability to fight infection

Ability to remember a prior exposure to a pathogen

A similar response to all pathogens encountered

Process of phagocytosis to destroy a pathogen

Which of the following is a unique characteristic of adaptive immunity?*

a. Ability to fight infection

b. Ability to remember a prior exposure to a pathogen

c. A similar response to all pathogens encountered

d. Process of phagocytosis to destroy a pathogen

b

Discovery of genetic principles underlying the generation of antibodies with different specificities:*

a. Edward Jenner

b. Ellie Metchnikoff

c. Emil von Behring

d. Susumu Tonegawa

d

Which of the following is characteristic of variable domains of immunoglobulins?*

a. They occur on both the H and L chains

b. They represent the complement-binding site

c. They are at the carboxy-terminal ends of the molecules

d. They are found only on H chains

a

Which antibody best protects mucosal surfaces?

a. IgA

b. IgD

c. IgG

d. IgM

a

The subclasses of IgG differ mainly in:*

a. Type of light chain

b. Arrangement of disulfide bonds

c. Ability to act as opsonin

d. Molecular weight

b

Which antibody is best at agglutination and complement fixation?*

a. IgA

b. IgG

c. IgD

d. IgM

d

All of the following are true of IgE EXCEPT that it:*

a. Fail to fix complement

b. Heat stable

c. Attaches to tissue mast cells

d. Found in the serum of allergic persons

b

Papain digestion of an IgG molecule results in which of the following?*

a. 2 Fab' and 1 Fc' fragment

b. F(ab')2 and 1 Fc' fragment

c. 2 Fab and 2 Fc fragments

d. 2 Fab and 1 Fc fragment

d

Which best characterizes the secondary response?*

a. Equal amounts of IgM and IgG are produced

b. There is an increase in IgM only

c. There is a large increase in IgG but not IgM

d. The lag phase is the same as in the primary respons

c

A patient in septic shock caused by a gram-negative bacterial infection exhibits the following symptoms: high fever, very low blood pressure, and disseminated intravascular coagulation. Which cytokine is the most likely contributor to these symptoms?*

a. IL-2

b. TNF

c. IL-12

d. IL-7

b

Why might a colony stimulating factor be given to a cancer patient?*

a. Stimulate activity of NK cells

b. Increase production of certain types of leukocytes

c. Decrease the production of TNF

d. Increase production of mast cells

b

A lack of C1-INH might result in which of the following conditions?*

a. Paroxysmal nocturnal hemoglobinuria

b. Hemolytic uremic syndrome

c. Hereditary angioedema

d. Increased bacterial infections

c

Which would be most effective in measuring an individual complement component?*

a. CH50 assay

b. Radial immunodiffusion

c, AH50 assay

c. Lytic assay with liposome

b

Which technique represents a single-diffusion reaction?*

a. Radial immunodiffusion

b. Ouchterlony diffusion

c. Immunoelectrophoresis

d. Immunofixation electrophoresis

a

Tiny agglutinates turbid background:*

a. 0

b. W+

c. 1+

d. 2+

e. 3+

f. 4+

b

A few isolated aggregates; mostly free-floating cells; supernatant appears red:*

a. Negative

b. Mixed-field

c. Weak

d. 1+

b

Several large aggregates; some free erythrocytes; clear supernatant:*

a. 1+

b. 2+

c. 3+

d. 4+

c

An HLA specimen is collected in a tube containing:*

a. ACD

b. EDTA

c. Silica

d. Thrombin

a

Which technique involves probe amplification rather than target amplification?*

a. Southern blot

b. PCR

c. Transcription-mediated amplification

d. Ligase chain reaction

d

Forward-angle light scatter is an indicator of cell:*

a. Granularity

b. Density

c. Size

d. Number

c

If an analyzer gets different results each time the same sample is tested, what type of problem does this represent?*

a. Sensitivity

b. Specificity

c. Accuracy

d. Precision

d

It is considered the gold standard in testing for contact dermatitis:*

a. RIST

b. RAST

c. Tuberculin test

d. Patch test

d

Which of the following would be considered a significant finding in Graves disease?*

a. Increased TSH levels

b. Antibody to TSH receptors

c. Decreased T3 and T4

d. Antithyroglobulin antibody

b

A 20-year-old woman made an appointment to see her physician because she was experiencing intermittent diarrhea. Laboratory testing revealed that she also had an iron deficiency anemia. To determine if the patient has CELIAC DISEASE, her doctor should order which of the following laboratory tests?

a. Anti-tTG

b. Antigliadin

c. Antigluten

d. All of the above

a

Antimitochondrial antibodies are strongly associated with which disease?*

a. Autoimmune hepatitis

b. Celiac disease

c. Primary biliary cirrhosis

d. Goodpasture's syndrome

c

Antigen receptors on T lymphocytes bind HLA class II+ peptide complexes with the help of which accessory molecule?*

a. CD2

b. CD3

c. CD4

d. CD8

c

he only blood group system that affects clinical transplantation:*

a. ABO

b. Rh

c. Kell

d. Duffy

a

The best use of serum tumor markers is considered to be in:*

a. Screening for cancer

b. Initial diagnosis of cancer

c. Monitoring patients undergoing cancer treatment

d. Determining patient prognosis

c

A woman with breast cancer is treated with a monoclonal antibody to HER2. This is an example of:*

a. A cancer vaccine

b. An immunotoxin

c. Passive immunotherapy

d. Active immunotherapy

c

What clinical manifestation would be seen in a patient with myeloperoxidase deficiency?*

a. Defective T-cell function

b. Inability to produce IgG

c. Defective NK cell function

d. Defective neutrophil function

d

A patient with a deficiency in complement component C7 would likely present with:*

a. Recurrent Staphylococcal infections

b. Recurrent Neisserial infections

c. Recurrent Escherichia coli infections

d. Recurrent Nocardia infections

b

Recurrent, periodic fevers may be associated with increased production of which immunoglobulin?*

a. IgG

b. IgM

c. IgD

d. IgE

c

Characteristics of a bacterial capsule include which of the following?*

a. It cannot be used for vaccine development

b. It is composed of peptidoglycan

It is an important mechanism for protecting a bacterium against ingestion by PMNs

d. It is what causes bacteria to stain as gram-negative

c