Immunology and Serology in Laboratory Medicine - Mary Louise Turgeon: Review Questions

d. Can protect against or be manipulated to treat disease.

An appropriate definition or description of the immune system is:

a. T and B types

b. Specific cellular elements, cell products, and nonlymphoid elements

c. Mononuclear cells

d. Can protect against or be manipulated to treat disease.

a. T and B types

An appropriate definition or description of lymphocytes is:

a. T and B types

b. Specific cellular elements, cell products, and nonlymphoid elements

c. Segmented cells

d. Condition in which the body's own tissues are attacked as if they were foreign

b. Specific cellular elements, cell products, and nonlymphoid elements

An appropriate definition or description of cooperative interaction is:

a. T and B types

b. Specific cellular elements, cell products, and nonlymphoid elements

c. Mononuclear cells

d. Can protect against or be manipulated to treat disease

c. Mononuclear phagocytes

An appropriate definition or description of nonspecific immune elements is:

a. T and B types

b. Specific cellular elements, cell products, and nonlymphoid elements

c. Mononuclear phagocytes

d. Condition in which the body's own tissues are attacked as if they were foreign

d. Condition in which the body's own tissues are attacked as if they were foreign

An appropriate definition or description of autoimmune disorder is:

a. T and B types

b. Specific cellular elements, cell products, and nonlymphoid elements

c. Mononuclear phagocytes

d. Condition in which the body's own tissues are attacked as if they were foreign

c. Phagocytic leukocytes

The first line of defense in protecting the body from infection includes all the following components except: a. Unbroken skin

b. Normal microbial microbiota

c. Phagocytic leukocytes

d. Secretions such as mucus

a. Innate or inborn

Natural immunity is characterized as being:

a. Innate or inborn

b. Able to recognize exogenous or endogenous agents specifically

c. Able to eliminate exogenous or endogenous agents selectively

d. Part of the first line of body defenses against microbial organisms

Cellular Mast cells Neutrophils 8. ________b. Macrophages ...Humoral Complement Lysozyme 9. _______d. Interferons

Complete the following chart from the available list of choices:

a. Lymphocytes

b. Macrophages

c. Mucus

d. Interferons

Components of the Natural Immune System

Cellular Mast cells Neutrophils 8. ________

Humoral Complement Lysozyme 9. _______

b. Acquired immunity

Another term for adaptive immunity is:

a. Antigenic immunity

b. Acquired immunity

c. Lymphocyte-reactive immunity

d. Phagocytosis

c. Antibodies

Humoral components of the adaptive immune system include:

a. T lymphocytes

b. B lymphocytes

c. Antibodies

d. Saliva

d. Infection

In adaptive immunity, the mode of acquisition of active natural immunity is:

a. Infusion of serum or plasma

b. Transfer in vivo or by colostrum

c. Vaccination

d. Infection

c. Vaccination

In adaptive immunity, the mode of acquisition of artificial active immunity is:

a. Infusion of serum or plasma

b. Transfer in vivo or by colostrum

c. Vaccination

d. Infection

a. Infusion of serum or plasma

In adaptive immunity, the mode of acquisition of passive natural immunity is:

a. Infusion of serum or plasma

b. Transfer in vivo or by colostrum

c. Vaccination

d. Infection

a. Infusion of serum or plasma

In adaptive immunity, the mode of acquisition of artificial passive immunity is:

a. Infusion of serum or plasma

b. Transfer in vivo or by colostrum

c. Vaccination

d. Infection

a. Is

In adaptive immunity acquired by active natural immunity, antibody __________ produced by the host.

a. Is

b. Is not

a. Is

In adaptive immunity acquired by artificial active immu nity, antibody __________ produced by the host.

a. Is

b. Is not

b. Is not

In adaptive immunity acquired by passive natural immu nity, antibody __________ produced by the host.

a. Is

b. Is not

b. Is not

In adaptive immunity acquired by artificial passive immu nity, antibody __________ produced by the host.

a. Is

b. Is not

b. Longer than

In adaptive immunity acquired by active natural immu nity, the duration of the presence of circulating antibody is __________ some other types of responses.

a. Shorter than

b. Longer than

c. Equivalent to

b. Longer than

In adaptive immunity acquired by artificial active immu nity, the duration of the presence of circulating antibody is __________ some other types of responses.

a. Shorter than

b. Longer than

c. Equivalent to

a. Shorter than

In adaptive immunity acquired by passive natural immu nity, the duration of the presence of circulating antibody is __________ some other types of responses.

a. Shorter than

b. Longer than

c. Equivalent to

a. Shorter than

In adaptive immunity acquired by artificial passive immu nity, the duration of the presence of circulating antibody is __________ other types of responses.

a. Shorter than

b. Longer than

c. Equivalent to

b. Epitope

A synonym for an antigenic determinant is:

a. Immunogen

b. Epitope

c. Binding site

d. Polysaccharide

a. Allogenic

Genetically different individuals of the same species are referred to as:

a. Allogenic

b. Heterogenic

c. Autogenic

d. Isogenic

d. All of the above

Antigenic substances can be composed of:

a. Large polysaccharides

b. Proteins

c. Glycoproteins

d. All of the above

d. Presence of large repeating polymers

Which of the following characteristics of an antigen is the least important?

a. Foreignness

b. Degradability

c. Molecular weight

d. Presence of large repeating polymers

a. Protein

The chemical composition of an antibody is:

a. Protein

b. Lipid

c. Carbohydrate

d. Any of the above

c. Has the highest molecular weight

The IgM antibody class:

a. Has the highest plasma or serum concentration in normal individuals

b. Has the shortest half-life

c. Has the highest molecular weight

d. Can exist as a dimer

a. Has the highest plasma or serum concentration in normal individuals

The IgG antibody class:

a. Has the highest plasma or serum concentration in normal individuals

b. Has the shortest half-life

c. Has the highest molecular weight

d. Can exist as a dimer

d. Can exist as a dimer

The IgA antibody class:

a. Has the highest plasma or serum concentration in normal individuals

b. Has the shortest half-life

c. Has the highest molecular weight

d. Can exist as a dimer

b. Has the shortest half-life

The IgE antibody class:

a. Has the highest plasma or serum concentration in normal individuals

b. Has the shortest half-life

c. Can exist as a dimer

d. Has no known subclasses

d. Has no known subclasses

The IgD antibody class:

a. Has the highest plasma or serum concentration in normal individuals

b. Has the shortest half-life

c. Can exist as a dimer

d. Has no known subclasses

b. Increased in infectious diseases, collagen disorders, and hematologic disorders

The characteristic associated with IgG is:

a. Predominant immunoglobulin in secretions

b. Increased in infectious diseases, collagen disorders, and hematologic disorders

c. Mediates some types of hypersensitivity reactions

d. Produced earliest in the immune response

d. Produced earliest in the immune response

The characteristic associated with IgM is:

a. Predominant immunoglobulin in secretions

b. Increased in infectious diseases, collagen disorders, and hematologic disorders

c. Mediates some types of hypersensitivity reactions

d. Produced earliest in the immune response

a. Predominant immunoglobulin in secretions

The characteristic associated with IgA is:

a. Predominant immunoglobulin in secretions

b. Increased in infectious diseases, collagen disorders, and hematologic disorders

c. Mediates some types of hypersensitivity reactions

d. Produced earliest in the immune response

d. Primarily a cell membrane immunoglobulin

The characteristic associated with IgD is:

a. Predominant immunoglobulin in secretions

b. Increased in infectious diseases, collagen disorders, and hematologic disorders

c. Mediates some types of hypersensitivity reactions

d. Primarily a cell membrane immunoglobulin

c. Mediates some types of hypersensitivity reactions

The characteristic associated with IgE is:

a. Predominant immunoglobulin in secretions

b. Increased in infectious diseases, collagen disorders, and hematologic disorders

c. Mediates some types of hypersensitivity reactions

d. Primarily a cell membrane immunoglobulin

b. Dominant type found on immunoglobulins of all animals of a species

A characteristic of an isotype is:

a. Found on the immunoglobulins of some, but not all, animals of a species

b. Dominant type found on immunoglobulins of all animals of a species

c. Individual determinants characteristic of each antibody

d. None of the above

a. Found on the immunoglobulins of some, but not all, animals of a species

A characteristic of an allotype is:

a. Found on the immunoglobulins of some, but not all, animals of a species

b. Dominant type found on immunoglobulins of all ani mals of a species

c. Individual determinants characteristic of each antibody

d. None of the above

c. Individual determinants characteristic of each antibody

A characteristic of an idiotype is:

a. Found on the immunoglobulins of some, but not all, animals of a species

b. Dominant type found on immunoglobulins of all animals of a species

c. Individual determinants characteristic of each antibody

d. None of the above

19.b. Lag phase 20.c. Log phase 21.a. Plateau

22. d. Decline

Arrange the sequence of events of a typical antibody response. 19. _______ 20. _______ 21. _______ 22. _______

a. Plateau

b. Lag phase

c. Log phase

d. Decline

d. IgM antibodies predominate

Which of the following statements is false about an anamnestic response versus a primary response?

a. Has a shorter lag phase

b. Has a longer plateau

c. Antibodies decline more gradually

d. IgM antibodies predominate

b. IgG

Which type of antibody is capable of placental transfer?

a. IgM

b. IgG

c. IgA

c. Ability of an antibody to combine with one antigen instead of another

Specificity is defined as:

a. Strength of a bond between a single antigenic determinant and an individual combining site

b. Noncovalent combination of an antigen with its respective specific antibody

c. Ability of an antibody to combine with one antigen instead of another

d. Strength with which a multivalent antibody binds to a multivalent antigen

a. Strength of a bond between a single antigenic determinant and an individual combining site

Affinity is defined as:

a. Strength of a bond between a single antigenic determinant and an individual combining site

b. Noncovalent combination of an antigen with its respective specific antibody

c. Ability of an antibody to combine with one antigen instead of another

d. Strength with which a multivalent antibody binds to a multivalent antigen

d. Strength with which a multivalent antibody binds to a multivalent antigen

Avidity is defined as:

a. Strength of a bond between a single antigenic determinant and an individual combining site

b. Noncovalent combination of an antigen with its respective specific antibody

c. Ability of an antibody to combine with one antigen instead of another

d. Strength with which a multivalent antibody binds to a multivalent antigen

b. Noncovalent combination of an antigen with its respective specific antibody

Immune complex is defined as:

a. Strength of a bond between a single antigenic determinant and an individual combining site

b. Noncovalent combination of an antigen with its respective specific antibody

c. Ability of an antibody to combine with one antigen instead of another

d. Strength with which a multivalent antibody binds to a multivalent antigen

d. All of the above

Which of the following type(s) of bonding is (are) involved in antigen-antibody reactions?

a. Hydrophobic

b. Hydrogen

c. Van der Waals

d. All of the above

b. Incomplete antibodies

Monovalent antibodies have also been referred to as: a. Complete antibodies

b. Incomplete antibodies

d. All of the above are correct

Which of the following is an accurate statement about monoclonal antibodies (MAbs)?

a. MAbs are antibodies engineered to bind to a single epitope

b. MAbs are purified antibodies cloned from a single cell

c. MAbs are used to classify and identify specific cellular membrane characteristics

d. All of the above are correct

c. Can be glycolipids or glycoproteins

Antigens are characterized as:

a. Not usually large organic molecules

b. Usually lipids

c. Can be glycolipids or glycoproteins

d. Are also called immunoglobulins

c. Its degree of foreignness

The immunogenicity of an antigen depends greatly on: a. Its biochemical composition

b. Being structurally unstable

c. Its degree of foreignness

d. Having a low molecular weight

a. Immunoglobulins

Antibodies are also referred to as:

a. Immunoglobulins

b. Haptens

c. Epitopes

d. Gamma globulins

a. Accounts for 10% of the Ig pool, largely confined to the intravascular space

An appropriate description of IgM is:

a. Accounts for 10% of the Ig pool, largely confined to the intravascular space

b. Mediates some types of hypersensitivity

c. Found in tears, saliva, colostrum, milk, and intestinal secretions

d. Diffuses more readily into extravascular spaces, neutralizes toxins, and binds to microorganisms

d. Diffuses more readily into extravascular spaces, neutralizes toxins, and binds to microorganisms

An appropriate description of IgG is:

a. Accounts for 10% of the Ig pool, largely confined to the intravascular space

b. Mediates some types of hypersensitivity

c. Found in tears, saliva, colostrum, milk, and intestinal secretions

d. Diffuses more readily into extravascular spaces, neutralizes toxins, and binds to microorganisms

c. Found in tears, saliva, colostrum, milk, and intestinal secretions

An appropriate description of IgA is:

a. Accounts for 10% of the Ig pool, largely confined to the intravascular space

b. Mediates some types of hypersensitivity

c. Found in tears, saliva, colostrum, milk, and intestinal secretions

d. Diffuses more readily into extravascular spaces, neutralizes toxins, and binds to microorganisms

b. Mediates some types of hypersensitivity

An appropriate description of IgE is:

a. Accounts for 10% of the Ig pool, largely confined to the intravascular space

b. Mediates some types of hypersensitivity

c. Found in tears, saliva, colostrum, milk, and intestinal secretions

d. Diffuses more readily into extravascular spaces, neutralizes toxins, and binds to microorganisms

d. Makes up less than 1% of total immunoglobulins

An appropriate description of IgD is:

a. Accounts for 10% of the Ig pool, largely confined to the intravascular space

b. Mediates some types of hypersensitivity

c. Found in tears, saliva, colostrum, milk, and intestinal secretions

d. Makes up less than 1% of total immunoglobulins

a. Composed of five basic subunits

Which of the following characterizes IgM?

a. Composed of five basic subunits

b. Less efficient in the activation of the complement cascade and agglutination than IgG

c. Less response in an initial antibody response

d. Predominant in a secondary (anamnestic) response

a. IgG is the predominant antibody type

In a secondary (anamnestic) response, a characteristic fea ture is:

a. IgG is the predominant antibody type

b. It has a longer lag phase

c. The antibody titer is lower

d. It has an accelerated decline in antibody response

d. Noncovalent bonding

Bonding of antigen to antibody exists exclusively as:

a. Hydrogen bonding

b. Van der Waals forces

c. Electrostatic forces

d. Noncovalent bonding

b. Goodness of fit

The strongest bond of antigen and antibody chiefly results from the:

a. Type of bonding

b. Goodness of fit

c. Antibody type

d. Quantity of antibody

b. Cloned from a single cell

Monoclonal antibodies have the characteristic of:

a. A diversified mixture of antibodies

b. Cloned from a single cell

c. Engineered to bind to a single specific antibody

d. Frequent occurrence in nature

a. Yolk sac

The site of hematopoiesis in the first month of gestation is the:

a. Yolk sac

b. Spleen

c. Liver

d. Bone marrow

d. Neutrophi

The principal type of leukocyte in the process of phagocy tosis is the:

a. Eosinophil

b. Basophil

c. Monocyte

d. Neutrophil

a. Oxidative metabolism

Chronic granulomatous disease represents a defect of: a. Oxidative metabolism

b. Abnormal granulation of neutrophils

c. Diapedesis

d. Chemotaxis

b. Suppression of the inflammatory response

A primary function of the eosinophil is:

a. Phagocytosis

b. Suppression of the inflammatory response

c. Response in acute, systemic hypersensitivity reactions

d. Antigen recognition

d. Both a and b

The cells of the mononuclear phagocyte system include:

a. Monocytes and promonocytes

b. Monocytes and macrophages

c. Lymphocytes and monocytes

d. Both a and b

d. All of the above

The host defense function(s) of monocytes-macrophages include(s):

a. Antigen presentation

b. Phagocytosis

c. Secretion of biologically active molecules

d. All of the above

a. Antigen recognition by T lymphocytes

The surface MHC class II gene product is important in: a. Antigen recognition by T lymphocytes

b. Antigen recognition by B lymphocytes

c. Synthesis of antibody by plasma cells

d. Phagocytosis

d. Corticosteroid therapy

An alteration of phagocytic killing is associated with:

a. Lazy leukocyte syndrome

b. Burns or diabetes

c. Systemic lupus erythematosus

d. Corticosteroid therapy

a. Wiskott-Aldrich syndrome

A defective monocyte cytotoxicity is associated with:

a. Wiskott-Aldrich syndrome

b. Burns or diabetes

c. Systemic lupus erythematosus

d. Corticosteroid therapy

d. Intracellular infections

A defective release of macrophage-activating factors is associated with:

a. Gaucher's syndrome

b. Burns or diabetes

c. Systemic lupus erythematosus

d. Intracellular infections

b. Burns or diabetes

A depressed migration is associated with:

a. Rheumatoid arthritis

b. Burns or diabetes

c. Systemic lupus erythematosus

d. Intracellular infections

c. Systemic lupus erythematosus

Impaired phagocytosis is associated with:

a. Lazy leukocyte

b. Burns or diabetes

c. Systemic lupus erythematosus

d. Intracellular infections

1.b. Increase in chemoattractants at site of tissue damage 2.d. Movement of phagocytic cells 3.c. Ingestion of bacteria 4.a. Digestion of bacteria

Arrange the steps of phagocytosis in the proper sequence 1._____ 2.______3. _____ 4. _____

a. Digestion of bacteria

b. Increase in chemoattractants at site of tissue damage c. Ingestionc. Ingestion of bacteria of bacteria

d. Movement of phagocytic cells

a. Primary phagocytic cells

The function of polymorphonuclear neutrophil (PMN) leukocytes is:

a. Primary phagocytic cells

b. Antibody-synthesizing cells

c. Recognition of foreign antigen and production of anti body

c. Participation in hypersensitivity reactions

Basophils are associated with:

a. Primary phagocytic cells

b. Antibody-synthesizing cells

c. Participation in hypersensitivity reactions

a. Phagocytic scavenger cells

The function of mononuclear monocytes-macrophages is:

a. Phagocytic scavenger cells

b. Antibody-synthesizing cells

c. Recognition of foreign antigen and production of anti body

b. Host defense

A recently recognized function of mononuclear mono cytes-macrophages is:

a. Primary phagocytic cells

b. Host defense

c. Recognition of foreign antigen and production of anti body

b. Yolk sac

The site of initial red blood cell production in the embryo and fetus is the:

a. Liver and spleen

b. Yolk sac

c. Bone marrow

a. Liver and spleen

The predominant site of red blood cell production during most of the time of fetal life is:

a. Liver and spleen

b. Yolk sac

c. Bone marrow

c. Bone marrow

The ultimate site of primary hematopoiesis in the embryo and fetus is the:

a. Liver and spleen

b. Yolk sac

c. Bone marrow

d. All of the above

Patients with a marked decrease in neutrophils or severe defects in neutrophil function have:

a. A high rate of infection

b. Recurrent systemic bacterial infections

c. Recurrent life-threatening fungal infections

d. All of the above

b. Failure to exhibit increased anaerobic metabolism during phagocytosisb

A characteristic of chronic granulomatosis disease is:

a. Marked defect in cellular response to chemotaxis

b. Failure to exhibit increased anaerobic metabolism during phagocytosisb

c. Mild-to-marked defectin bactericidal ability of neutrophils

d. Defective leukocyte locomotion

d. Defective leukocyte locomotion

A characteristic of lazy leukocyte syndrome is:

a. Marked defect in cellular response to chemotaxis

b. Failure to exhibit increased anaerobic metabolism during phagocytosis

c. Mild-to-marked defect in bactericidal ability of neutrophils

d. Defective leukocyte locomotion

a. Marked defect in cellular response to chemotaxis

A characteristic of Chédiak-Higashi anomaly (syndrome) is:

a. Marked defect in cellular response to chemotaxis

b. Failure to exhibit increased anaerobic metabolism during phagocytosis

c. Mild-to-marked defect in bactericidal ability of neutrophils

d. Defective leukocyte locomotion

c. Mild-to-marked defect in bactericidal ability of neutrophils

A characteristic of myeloperoxidase deficiency is:

a. Marked defect in cellular response to chemotaxis

b. Failure to exhibit increased anaerobic metabolism during phagocytosis

c. Mild-to-marked defect in bactericidal ability of neutrophils

d. Defective leukocyte locomotion

d. They interact with the larval stages of some helminth parasites

Which statement about eosinophils is correct?

a. They are not homeostatic regulators of inflammation b. They do not attempt to suppress an inflammatory reaction

c. They participate in hypersensitivity reactions

d. They interact with the larval stages of some helminth parasites

b. They have a high concentration of histamine in the granules

Which statement about basophils is correct?

a. They have a low concentration of heparin in the granules

b. They have a high concentration of histamine in the granules

c. They react with two adjacent IgA molecules on mast cells

d. They are not associated with anaphylactic shock

d. Polymorphonuclear neutrophils

The cells that constitute the physiologic, mononuclear phagocyte system do not include:

a. Promonocytes and their precursors

b. Monocytes in circulating blood

c. Macrophages in tissues

d. Polymorphonuclear neutrophils

b. initiation of rejection of foreign tissues and tumors

A function of the cell-mediated immune response not associated with humoral immunity is:

a. defense against viral and bacterial infection

b. initiation of rejection of foreign tissues and tumors

c. defense against fungal and bacterial infection

d. antibody production

c. bone marrow and/or fetal liver and thymus

The primary or central lymphoid organs in humans are the:

a. bursa of Fabricius and thymus

b. Lymph nodes and thymus

c. bone marrow and/or fetal liver and thymus

d. lymph nodes and spleen

d. synthesis of antibody

All of the following are a function of T cells except:

a. Mediation of delayed-hypersensitivity reactions

b. Mediation of cytolytic reactions

c. Regulation of the immune response

d. synthesis of antibody

b. cellular immune response

4. The function of T cells is:

a. Antibody-dependent, cell-mediated cytotoxicity (ADCC) reaction

b. cellular immune response

c. cytotoxic reaction

d. humoral response

b. cellular immune response

The function of B cells is:

a. Antibody-dependent, cell-mediated cytotoxicity (ADCC) reaction

b. cellular immune response

c. cytotoxic reaction

b. cellular immune response

a. Antibody-dependent, cell-mediated cytotoxicity (ADCC) reaction

The function of K-type lymphocytes is:

a. Antibody-dependent, cell-mediated cytotoxicity (ADCC) reaction

b. cellular immune response

c. cytotoxic reaction

d. humoral response

c. cytotoxic reaction

The function of natural killer (NK) cells is:

a. Antibody-dependent, cell-mediated cytotoxicity (ADCC) reaction

b. cellular immune response

c. cytotoxic reaction

d. humoral response

b. Helper-inducer T cells

The surface membrane marker for CD4 is:

a. All or most T lymphocytes

b. Helper-inducer T cells

c. Suppressor-cytotoxic T cells

b. Helper-inducer T cells

The surface membrane marker for CD8 is:

a. All or most T lymphocytes

b. Helper-inducer T cells

c. Suppressor-cytotoxic T cells