ELSEVIER: IMMUNOSERO

Which statement is true regarding the radial immunodiffusion test?

a. The area of the precipitin ring indicates a partial identity to the antibody in the sample

b. The area of the precipitin ring is directly proportional to the concentration of antigen in the sample

c. The area of the precipitin ring is directly proportional to the concentration of antibody in the sample

d. The area of the precipitin ring is directly proportional to the concentration antibody and the antigen in the sample

b. The area of the precipitin ring is directly proportional to the concentration of antigen in the sample

___ are involved in cell-mediated immunity, ___ whereas are involved in humoral immunity

a. T cells, B cells

b. B cells, T cells

c. T cells, antibodies

d. A and B

d. A and B

______ protect from viral infection by recognizing and destroying infected cells and ______ protect us indirectly by producing cytokines to stimulate B cells.

a. NK cells; CD8+ T helper lymphocytes

b. CD8+ cytotoxic T lymphocytes; CD4+ T helper lymphocytes

c. CD4+ cytotoxic T lymphocytes; CD8+ T helper lymphocytes

d. NK cells; CD4+ cytotoxic T lymphocytes

b. CD8+ cytotoxic T lymphocytes; CD4+ T helper lymphocytes

A 1-year-old boy is seen for having many recurrent infections with Streptococcus pneumoniae. Laboratory tests revealed a normal quantity of T cells, but no B cells and no immunglobulins were seen on electrophoresis. Which of the following would most likely be the cause?

a. DiGeorge's syndrome

b. Chronic granulotomatous disease

c. Wiskott-Aldrich syndrome

d. Bruton's agammaglobulinemia

d. Bruton's agammaglobulinemia

A 2-week-old baby is seen for a possible infection with CMV. Which of the following statements is false?

a. An initial titer of anti-CMV IgG would need to be established

b. All are false statements

c. A positive result for anti-CMV IgM would indicate infection

d. A positive anti-CMV result from baby's specimen is inconclusive

a. An initial titer of anti-CMV IgG would need to be established

A 25-year-old man was seen by his physican for recurrent infections. Immunoelectrophoresis revealed hypogammaglobulinemia. This man most likely has which of the following?

a. X-linked agammaglobulinemia

b. Bruton's agammaglobulinemia

c. DiGeorge's syndrome

d. Common variable immunodeficiency

d. Common variable immunodeficiency

A 3-year-old boy is seen by his physican because of many recent bacterial infections. Flow cytometery indicates normal levels of T and B cells. The nitroblue tetrazolium test for oxidative reduction is negative. The most likely cause is

a. Bruton's agammaglobulinemia

b. Wegener's syndrome

c. Chronic granulomatous disease d. Diabetes mellitus

c. Chronic granulomatous disease

A deficiency of T cells can result in which of the following?

a. Dysfunctional macrophages

b. Low levels of complement

c. Fewer B cells maturing to plasma cells

d. Contact dermatitis

c. Fewer B cells maturing to plasma cells

A deficiency of T-cells can result contact dermatitis and low level of complement.

a. False

b. True

a. False

A double-positive T cell would express which markers?

a. CD4 CD8 + CD3+

b. CD4 +CD8-CD3+

c. CD4+CD8+CD3+

d. CD4

c. CD4+CD8+CD3+

A laboratory is evaluating an enzyme-linked immunosorbent assay (ELISA) for detecting an antibody to cyclic citrullinated peptide (CCP),which is a marker for rheumatoid arthritis. The laboratory includes serum from healthy volunteers and patients with other connective tissue diseases in the evaluation. These specimens determine which factor of the assay?

a. Bias

b. Sensitivity

c. Specificity

d. Precision

c. Specificity

A latex agglutination test for cardiolipin is performed on a patient suspected of having which disease?

a. Syphilis

b. The patient may be pregnant

c. Rheumatoid arthritis

d. Infectious mononucleosis

a. Syphilis

A newborn is to be tested for a vertically transmitted HIV infection. Which of the following tests is most useful?

a. CD4 count

b. Rapid HIV antibody test

c. HIV PCR

d. HIV IgM antibody test

c. HIV PCR

A patient has the following hepatitis B serology-HBsAgNegative, Anti-HBc- Positive , Anti-HBS-Positive. These results are consistent with which of the following?

a. Chronic hepatitis B

b. Recovery from hepatitis B

c. Acute hepatitis A

d. Acute hepatitis B

b. Recovery from hepatitis B

A patient sample tested positive for anti-dsDNA antibodies. The patient most likely has which of the following?

a. Rheumatoid arthritis

b. Infectious mononucleosis

c. Systemic lupus erythematosus

d. Syphilis

c. Systemic lupus erythematosus

A patient with a viral infection to the ABC virus is found to have a high antibody titer to the ABC virus's RNA, or anti-ABCr, Which of the following is true?

a. MHC class II molecules presented antigen to CD8+ T cells b. MHC class I molecules presented antigen to CD8+ T cells c. MHC class II molecules presented antigen to CD4+ T cells d. MHC class I molecules presented antigen to CD4+ T cells

b. MHC class I molecules presented antigen to CD8+ T cells

A patient with hereditary angiodema has which of the following deficiencies?

a. Phagocytic cell function

b. Mature B cells

c. C1 Inhibitor

d. C5-9

c. C1 Inhibitor

A patient with hereditary angiodema has which of the following deficiencies?

a. C1 Inhibitor

b. Phagocytic cell function

c. none

d. both A and B

a. C1 Inhibitor

A person has an infected bug bite with pain, swelling, and redness. What is the cause of these physical symptoms of inflammation?

a. Production of antibody

b. Activation of NK cells

c. Increased blood flow and neutrophils to site

d. Secondary immune response

c. Increased blood flow and neutrophils to site

A radiograph of a 1-year-old boy indicates the lack of a thymus. Complete blood count and flow cytometry confirm a belownormal lymphocyte count and a lack of T cells. Which of the following would most likely be the cause?

a. Wiskott-Aldrich syndrome

b. Bare lymphocyte syndrome

c. DiGeorge's syndrome

d. Bruton's agammaglobulinemia

c. DiGeorge's syndrome

Agglutination and precipitation that is visible depends on antigen-antibody ratios ________.

a. With antibody in excess

b. All of the above

c. That are equivalent

d. With antigen in excess

c. That are equivalent

All of the following are autoimmune diseases except

a. Myasthenia gravis

b. Grave's disease

c. Rheumatoid arthritis

d. Rh disease of the fetus and newborn

d. Rh disease of the fetus and newborn

An agglutination test that detects antibodies in patient with rickettsial infection

a. RPR

b. ASO

c. Widal Felix

d. Torch Testing

c. Widal Felix

An autoantibody found in patients with Hashimoto's thyroiditis reacts with which of the following?

a. TSH receptor

b. Thyroglobulin

c. Islet cells

d. CRP

b. Thyroglobulin

An initial titer of 4 followed by a subsequent titer of 16 for the same patient, drawn 2 weeks later, is indicative of which of the following?

a. Past exposure

b. Infection

c. No exposure

d. Convalescence

b. Infection

Anti-dsDNA antibodies are associated with Cytomegalo Virus.

a. False

b. True

a. False

Anti-dsDNA antibodies are associated with which of the following?

a. Systemic lupus erythematosus

b. CMV infection

c. Syphilis

d. Hemolytic anemia

a. Systemic lupus erythematosus

Antibodies produced against two or more epitopes of specific antigen are considered ____________.

a. Dimorphic

b. Polyclonal

c. Monoclonal

d. Pleomorphic

b. Polyclonal

Antibodies produced against two or more epitopes of specific antigen are considered Pleomorphic.

a. True

b. False

b. False

Antigens that make very good immunogens include which of the following?

a. Proteins

b. Neither a or b

c. Both a and b

d. Carbohydrates

a. Proteins

Antigens that make very good immunogens include which of the following?

a. Both a and b

b. Neither a or b

c. Proteins

d. Minerals

c. Proteins

Characteristics of cytokines include which of the following?

a. All of the above

b. Cytokines enhance cellular differentiation of lymphocytes

c. They can have a pleomorphic effect

d. Cytokines are redundant

a. All of the above

Examples of type I hypersensitivity

a. Urticaria

b. All of the above

c. Hay fever

d. Anaphylactic reactions to bee stings, venom, peanut allergies e. Asthma

b. All of the above

IgM spike on electrophoresis can be seen in

a. None of the above

b. Both A and B

c. Transient hypogammaglobulinemia of infancy

d. Wiskott-Aldrich syndrome

a. None of the above

Immunoglobulin idiotypes are antibodies with variations in the domains of which of the following?

a. VH and CL

b. CH1 and CH2

c. CH1, CH2, and CH3

d. VH and VL

d. VH and VL

Immunoglobulins function by all of the following except

a. Reneutralize toxins produced by viruses

b. Lyse viruses by activating T cells c. Activate complement cascade of cell lysis

d. Coat invading cells to act as opsonins

b. Lyse viruses by activating T cells

In an indirect immunofluorescent antibody test for CMV antibodies, the conjugated antibody used for visualizing is

a. Antihuman globulin conjugated to a fluorescent dye

b. CMV virus conjugated to a fluorescent dye

c. Anti-CMV antibody conjugated to a fluorescent dye

d. Antihuman globulin conjugated to an enzyme

a. Antihuman globulin conjugated to a fluorescent dye

In an Ouchterlony immunodiffusion, the line of precipitation between the antibody and the antigen wells forms an X, This reaction would be described as which of the following?

a. Nonidentity

b. Identity

c. Partial identity

a. Nonidentity

n Grave's disease, one of the main autoantibodies is

a. Anti-CCP

b. Antibody to islet cells of pancreas

c. Antibody to thyroid-stimulating hormone receptor

d. Anti-dsDNA

c. Antibody to thyroid-stimulating hormone receptor

In the radial immunodiffusion test, the gel contains which of the following?

a. Antibody

b. The antigen to be tested

c. Patient sample

d. None of the above, the gel is the medium to which the antibody and antigen are applied in equal proportion

a. Antibody

In which disease would you expect to see an IgM spike on electrophoresis?

a. Leukocyte adhesion disease

b. Transient hypogammaglobulinemia of infancy

c. Wiskott-Aldrich syndrome

d. Waldenstrom's macroglobulinemia

d. Waldenstrom's macroglobulinemia

It is a panel of serologic procedures used to detect a group of viruses and other organism that cause congenital disease

a. Torch testing

b. ELISA

c. FTA-ABS

d. VDRL

a. Torch testing

Mannose-binding lectin is similar to which component of the classical pathway?

a. C5a

b. C2

c. C3

d. C1q

d. C1q

Mannose-binding lectin is similar to which component of the classical pathway?

a. Both a and b

b. C1q

c. C2 and C5a

d. Neither a or b

b. C1q

Mast cell is implicated in immediate hypersensitivity.

a. True

b. False

a. True

Natural barriers of the immune system include all except which of the following?

a. pH of secretions

b. Intestinal bacteria

c. Coughing

d. Hair follicles

d. Hair follicles

Natural barriers of the immune system include the pH of secretions, coughing and hair follicles?

a. True

b. False

b. False

Nephlometry measures light transmitted through a solution, and turbidimetry measures light scattered in a solution.

a. False

b. True

b. True

Neutrophils and monocytes have receptors for which part of the immunoglobulin molecule?

a. Variable region

b. Fab

c. Fc

d. Hinge region

c. Fc

One B-cell marker of early-stage B-cell development is _____, whereas ____ is a marker for later stages of B-cell development

a. CD19, CD10

b. CD10, CD20

c. CD21, CD10

d. CD20, CD10

b. CD10, CD20

Postzone causes false-negative reactions in antibody titers as a result of which of the following?

a. Excess antigen in test

b. Too much diluent added to test c. Excess antibody in test

d. Incorrect diluent added to test

a. Excess antigen in test

Radial Immunodiffusion Test is the area of the precipitin ring that is directly proportional to the concentration of antibody in the sample.

a. False

b. True

a. False

Recepients of transplant are:

a. None of the above

b. HLA matched with a donor

c. HLA type

d. Cross-matched to rule out

e. All of the above

e. All of the above

RF factors is not specific for Rheumatoid arthritis

a. false

b. True

b. True

Rh disease of the fetus and newborn is an example of autoimmune disease.

a. False

b. True

a. False

Rheumatoid factor is typically an IgM autoantibody with specificity for which of the following?

a. SS-B

b. Ribonucleoprotein

c. Fc portion of IgG

d. Double-stranded DNA

c. Fc portion of IgG

Rheumatoid factor is typically an IgM autoantibody with specificity for which of the following?

a. None of the above

b. Both A and B

c. Double-stranded DNA

d. SS-B

a. None of the above

Serum tested positive for HBsAg and anti-HBc IgM. The patient most likely has which of the following?

a. Acute hepatitis C

b. Acute hepatitis A

c. Chronic hepatitis B

d. Acute hepatitis B

d. Acute hepatitis B

Severe combined immunodeficiency is characterized by which of the following?

a. Diagnosed in infancy

b. Shortened life span

c. No antibody production

d. All of the above

d. All of the above

Skin testing for exposure to tuberculosis is an example of which type of hypersensitivity?

a. Type III

b. Type I

c. Type II

d. Type IV

d. Type IV

The antibody associated with type IV hypersensitivity is

a. IgG

b. None of the above

c. IgE

d. IgM

e. IgA

b. None of the above

The detection of precipitation reactions depends on the presence of optimal proportions of antigen and antibody. A patient's sample contains a large amount of antibody, but the reaction in a test system containing antigen is negative. What has happened?

a. A shift in the zone of equivalence b. Low specificity

c. Performance error

d. Prozone phenomenon

d. Prozone phenomenon

The following are characteristics of cytokines except?

a. has a double-stranded DNA

b. Cytokines enhance cellular differentiation of lymphocytes

c. Cytokines are redundant

d. They can have a pleomorphic effect

a. has a double-stranded DNA

The following are considered as Type III Hypersensitivity

a. Rheumatoid Arthritis

b. Neither

c. Both A & B

d. SLE

c. Both A & B

The following best describes Varicella-zoster except

a. After initial infection, virus lies dormant

b. Intestinal disease

c. causes a rashes that blister and form scabs in recovery

d. Can be transmitted through fecal-oral route

d. Can be transmitted through fecal-oral route

The following is (are)benefit (s) of T cells in transplant; graft versus Leukemia

a. Promote cellular engraftment

b. Both A and B

c. Improve immune system

d. Neither A or B

b. Both A and B

The following results happen When C3 is cleaved by C3 convertase, except?

a. C3b is used as an opsonin

b. C3a is released

c. Calcium is released

d. C3b is combined with other complement proteins to form C5 convertase

c. Calcium is released

The function of the complement system include(s) which of the following?

a. Clearance of cellular debris

b. Chemotaxis

c. All of the above

d. Lysis of bacteria

c. All of the above

The fundamental difference between primary and secondary organs of the lymphatic system is

a. Antibody production occurs only in the primary lymph organs

b. Maturation of lymphocytes occurs in primary organs, and activation occurs in secondary organs

c. Complement production occurs only in the primary lymph organs

d. Maturation of lymphocytes occurs in secondary organs, and activation occurs in primary organs

b. Maturation of lymphocytes occurs in primary organs, and activation occurs in secondary organs

The HLA genes are inherited as

a. Only the HLA-A antigen is an inheritable trait

b. Diplotypes, Two diplotypes from each parent

c. Haplotypes, One haplotype from each parent

d. HLAs are not inherited, instead are proteins absorbed onto cells

c. Haplotypes, One haplotype from each parent

The immunoglobulin typically found in secretions is

a. IgD

b. IgG

c. IgA

d. IgM

e. IgE

c. IgA

The indirect antiglobulin test is for ______________, whereas the direct antiglobulin test is for__________.

a. Serum antibody, bound antibody

b. Serum antigen, bound antibody c. Serum antigen, bound antigen

d. Serum antibody, bound antigen

a. Serum antibody, bound antibody

The indirect antiglobulin test is for serum antigen, whereas the direct antiglobulin test is for bound antigen.

a. True

b. False

b. False

The main difference between leukemias and lymphomas is which of the following?

a. Leukemias are malignancies of cells in the bone marrow

b. Leukemias are malignancies in lymphoid tissue

c. Lymphomas are malignancies of cells in the bone marrow

d. Lymphomas are classified as either acute or chronic

a. Leukemias are malignancies of cells in the bone marrow

The RPR test is read microscopically, whereas the VDRL is read macroscopically.

a. False

b. True

a. False

The type of graft rejection that occurs within minutes of a tissue transplant is ____________.

a. Hyperacute

b. Chronic

c. Acute

d. Accelerated

e. CD19; CD10

a. Hyperacute

Toll-like receptor aid in processing antigen in the form of an MHC molecule.

a. True

b. False

b. False

Toll-like receptors act in which way?

a. Enhance recognition of bacteria by phagocytic cells

b. Activate B cells to produce antibody

c. Aid in processing antigen in the form of an MHC molecule

d. Activate helper T cells

a. Enhance recognition of bacteria by phagocytic cells

What corrective action should be taken when an indeterminate pattern occurs in an indirect IFA?

a. Repeat the test using a larger volume of sample

b. Dilute the sample and retest

c. Have another medical laboratory scientist read the slide

d. Call the physician

b. Dilute the sample and retest

What immune elements are involved in a positive skin test for tuberculosis?

a. IgE antibodies

b. B cells and IgM antibody

c. T cells and macrophages

d. NK cells and IgG antibody

c. T cells and macrophages

What is the basic difference between the RPR and VDRL tests? a. There is no difference because they are both specific tests for syphilis

b. The RPR test is read macroscopically, whereas the VDRL is read microscopically

c. The RPR detects antigen, whereas the VDRL detects antibody d. The RPR test is a treponemal test, whereas the VDRL is nontreponemal

b. The RPR test is read macroscopically, whereas the VDRL is read microscopically

What is the difference between nephlometry and turbidimetry?

a. Nephlometry measures light scattered in a solution, and turbidimetry measures light transmitted through a solution

b. Nephlometry is a newer example of turbidimetry

c. There is no difference between the two assays, only in name

d. Nephlometry measures light transmitted through a solution, and turbidimetry measures light scattered in a solution

a. Nephlometry measures light scattered in a solution, and turbidimetry measures light transmitted through a solution

What method may be used for tissue typing instead of serological HLA typing?

a. Southern blotting

b. RFLP

c. PCR

d. All of the above

d. All of the above

What is the main difference between agglutination and precipitation reactions?

a. Precipitation occurs when the antigen is particulate

b. Precipitation occurs when both antigen and antibody are particulate

c. Agglutination occurs between a soluble antigen and antibody

d. Agglutination occurs when the antigen is particulate

d. Agglutination occurs when the antigen is particulate

What substance is detected by the rapid plasma reagin (RPR) and Venereal Disease Research Laboratory (VDRL) tests for syphilis?

a. Anticardiolipin antibody

b. Treponema pallidum

c. Anti-T. pallidum antibody

d. Cardiolipin

a. Anticardiolipin antibody

When C3 is cleaved by C3 convertase, what is the result?

a. C3b is used as an opsonin

b. C3b is combined with other complement proteins to form C5 convertase

c. C3a is released

d. All of the above

d. All of the above

Which cell is considered to be a bridge between the innate and adaptive immune systems?

a. Monocyte-macrophage

b. T cell

c. Mast cell

d. NK cell

d. NK cell

Which cluster of differentiation (CD) marker appears during the first stage of T-cell development and remains present as an identifying marker for T cells?

a. CD2

b. CD3

c. CD4 or CD8

d. CD1

a. CD2

Which hepatitis antibody confers immunity against reinfection with hepatitis B virus?

a. Anti-HBc IgG

b. Anti-HBc IgM

c. Anti-HBs

d. Anti-HBe

c. Anti-HBs

Which immunoglobulin class(es) has (have) a J chain?

a. IgE and IgD

b. IgG3 and IgA

c. IgM and sIgA

d. IgM

c. IgM and sIgA

Which method is the most sensitive for quantitation of AFP?

a. Electrophoresis

b. Enzyme immunoassay

c. Particle agglutination

d. Double immunodiffusion

b. Enzyme immunoassay

Which method is used to test for HIV infection in infants who are born to HIV-positive mothers?

a. ELISA

b. Polymerase chain reaction

c. Western blot test

d. Viral culture

b. Polymerase chain reaction

Which of the following are examples autoimmune diseases

a. All of the above

b. Rheumatoid arthritis

c. Myasthenia gravis

d. None of the above e. Grave's disease

a. All of the above

Which of the following cell types is implicated in immediate hypersensitivity?

a. Neutrophil

b. Macrophage

c. Monocyte

d. Mast cell

d. Mast cell

Which of the following is a test for specific treponemal antibody?

a. RPR

b. All of the above

c. VDRL

d. FTA-ABS

d. FTA-ABS

Which of the following is used in rapid slide tests for detection of rheumatoid factors?

a. Fc portion of the IgG molecule

b. Fab portion of the IgG molecule c. Fc portion of the IgM moleculehese options

d. Whole IgM molecules

c. Fc portion of the IgM moleculehese options

Which of the following substances, sometimes used as a tumor marker, is increased two- or threefold in a normal pregnancy?

a. Adrenocortocotropic hormone (ACTH)

b. Calcitonin

c. Alkaline phosphatase (ALP)

d. Neuron-specific enolase

c. Alkaline phosphatase (ALP)

Which one of the following tests on donor units is not required?

a. Anti-EBV

b. Anti-HCV

c. Antibody screen

d. West Nile virus

a. Anti-EBV

Which part of the radial immunodiffusion (RID) test system contains the antisera?

a. Antisera may be added to any well

b. Gel

c. Center well

d. Outer wells

b. Gel

Which region of the immunoglobulin molecule can bind antigen?

a. Fc

b. Fab

c. CH

d. CL

b. Fab