CH6 Immunology & Serology (Med Lab Exam Practice)

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

a. pH of secretions

b. Coughing

c. Hair follicles

d. Intestinal bacteria

c. Hair follicles

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

a. Antibody production occurs only in the primary lymph organs

b. Complement production occurs only in the primary lymph organs

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

d. Maturation of lymphocytes occurs in primary

d. Maturation of lymphocytes occurs in primary

Toll-like receptors act in which way?

a. Enhance recognition of bacteria by phagocytic cells

b. Activate B cells to produce antibody

c. Activate helper T cells

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

a. Enhance recognition of bacteria by phagocytic cells

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

a. Fc

b. Fab

c. Hinge region

d. Variable region

a. Fc

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

a. CD20; CD10

b. CD21; CD10

c. CD10; CD20

d. CD19; CD10

c. CD10; CD20

A double-positive T cell would express which markers?

a. CD4+CD8+CD3+

b. CD4CD8+CD3+

c. CD4CD8CD3

d. CD4+CD8-CD3+

a. CD4+CD8+CD3+

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

a. NK cell

b. Mast cell

c. Monocyte-macrophage

d. T cell

a. NK cell

_______ are involved in cell-mediated immunity, whereas _______ are involved in humoral immunity.

a. T cells; B cells

b. T cells; antibodies

c. B cells; T cells

d. A and B

d. A and B

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

a. Carbohydrates

b. Proteins

c. Both a and b

d. Neither a or b

b. Proteins

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

a. Clearance of cellular debris

b. Chemotaxis

c. Lysis of bacteria

d. All of the above

d. All of the above

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

a. C3a is released

b. C3b is used as an opsonin

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

d. All of the above

d. All of the above

Characteristics of cytokines include which of the following?

a. They can have a pleomorphic effect

b. Cytokines are redundant

c. Cytokines enhance cellular differentiation of

lymphocytes

d. All of the above

d. All of the above

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

a. CH^1 and CH^2

b. VH and VL

c. VH and CL

d. CH^1, CH^2, and CH^3

b. VH and VL

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

a. C3

b. C2

c. C1q

d. C5a

c. C1q

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 I molecules presented antigen to CD4+ T cells

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

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

d. MHC class II molecules presented antigen to CD4+ T cells

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

What is the main difference between agglutination and precipitation reactions?

a. Agglutination occurs between a soluble antigen and antibody

b. Agglutination occurs when the antigen is particulate

c. Precipitation occurs when the antigen is particulate

d. Precipitation occurs when both antigen and antibody are particulate

b. Agglutination occurs when the antigen is particulate

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

a. Too much diluent added to test

b. Excess antibody in test

c. Excess antigen in test

d. Incorrect diluent added to test

c. Excess antigen in test

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

a. Monoclonal

b. Pleomorphic

c. Dimorphic

d. Polyclonal

d. Polyclonal

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

a. The antigen to be tested

b. Antibody

c. Patient sample

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

b. Antibody

Which statement is true regarding the radial immunodiffusion test?

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

sample

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

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

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

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

sample

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

a. Serum antigen; bound antigen

b. Serum antigen; bound antibody

c. Serum antibody; bound antigen

d. Serum antibody; bound antibody

d. Serum antibody; bound antibody

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. Anti-CMV antibody conjugated to a fluorescent dye

c. CMV virus conjugated to a fluorescent dye

d. Antihuman globulin conjugated to an enzyme

a. Antihuman globulin conjugated to a fluorescent dye

What is the difference between nephlometry and turbidimetry?

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

b. Nephlometry is a newer example of turbidimetry

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

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

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

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. Partial identity

c. Identity

a. Nonidentity

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. Infection

b. Convalescence

c. Past exposure

d. No exposure

a. Infection

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

a. Low levels of complement

b. Dysfunctional macrophages

c. Fewer B cells maturing to plasma cells

d. Contact dermatitis

c. Fewer B cells maturing to plasma cells

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

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

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

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

d. All are false statements

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

What is the basic difference between the RPR and

VDRL tests?

a. The RPR detects antigen, whereas the VDRL detects antibody

b. The RPR test is read macroscopically, whereas the

VDRL is read microscopically

c. The RPR test is a treponemal test, whereas the VDRL is nontreponemal

d. 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

A patient has the following hepatitis B serology:

HBsAg: Negative

Anti-HBc: Positive

Anti-HBS: Positive

These results are consistent with which of the following?

a. Acute hepatitis B

b. Chronic hepatitis B

c. Recovery from hepatitis B

d. Acute hepatitis A

c. Recovery from hepatitis B

The HLA genes are inherited as:

a. Diplotypes: Two diplotypes from each parent

b. Haplotypes: One haplotype from each parent

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

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

b. Haplotypes: One haplotype from each parent

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

a. With antigen in excess

b. With antibody in excess

c. That are equivalent

d. All of the above

c. That are equivalent

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

a. Neutrophil

b. Mast cell

c. Macrophage

d. Monocyte

b. Mast cell

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

a. Syphilis

b. CMV infection

c. Systemic lupus erythematosus

d. Hemolytic anemia

c. Systemic lupus erythematosus

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

a. SS-B

b. Double-stranded DNA

c. Ribonucleoprotein

d. Fc portion of IgG

d. Fc portion of IgG

All of the following are autoimmune diseases except:

a. Rheumatoid arthritis

b. Rh disease of the fetus and newborn

c. Grave's disease

d. Myasthenia gravis

b. Rh disease of the fetus and newborn

In 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

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

a. TSH receptor

b. Islet cells

c. CRP

d. Thyroglobulin

d. Thyroglobulin

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

a. Type I

b. Type II

c. Type III

d. Type IV

d. Type IV

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

a. VDRL

b. RPR

c. FTA-ABS

d. All of the above

c. FTA-ABS

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

a. Acute hepatitis C

b. Chronic hepatitis B

c. Acute hepatitis B

d. Acute hepatitis A

c. Acute hepatitis B

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

a. Leukemias are malignancies of cells in the bone marrow

b. Lymphomas are maligniancies of cells in the bone marrow

c. Lymphomas are classified as either acute or chronic

d. Leukemias are malignancies in lymphoid tissue

a. Leukemias are malignancies of cells in the bone marrow

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. Chronic granulotomatous disease

b. Bruton's agammaglobulinemia

c. DiGeorge's syndrome

d. Wiskott-Aldrich syndrome

b. Bruton's agammaglobulinemia

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

a. C5-9

b. Phagocytic cell function

c. Mature B cells

d. C1 Inhibitor

d. C1 Inhibitor

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

a. DiGeorge's syndrome

b. Wiskott-Aldrich syndrome

c. Bare lymphocyte syndrome

d. Bruton's agammaglobulinemia

a. DiGeorge's syndrome

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

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

a. Wegener's syndrome

b. Chronic granulomatous disease

c. Bruton's agammaglobulinemia

d. Diabetes mellitus

b. Chronic granulomatous disease

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. Bruton's agammaglobulinemia

b. Common variable immunodeficiency

c. X-linked agammaglobulinemia

d. DiGeorge's syndrome

b. Common variable immunodeficiency

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

a. Transient hypogammaglobulinemia of infancy

b. Wiskott-Aldrich syndrome

c. Leukocyte adhesion disease

d. Waldenstrom's macroglobulinemia

d. Waldenstrom's macroglobulinemia

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. Secondary immune response

c. Increased blood flow and neutrophils to site

d. Activation of NK cells

c. Increased blood flow and neutrophils to site

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

a. Acute

b. Chronic

c. Hyperacute

d. Accelerated

c. Hyperacute