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SEROLOGY MTAP 1 > BOC Study Guide PART 2 (CHAPTER REVIEW) > Flashcards

BOC Study Guide PART 2 (CHAPTER REVIEW) Flashcards

1
Q
  1. Which of the following is a true statement about Bruton
    agammaglobulinemia?

a. it is found only in females
b. there are normal numbers of circulating B cells
c. there are decreased to absent concentrations of immunoglobulins
d. the disease presents with pyogenic infections 1wek after
birth

A

c. there are decreased to absent concentrations of
immunoglobulins

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2
Q
  1. Immunodeficiency with thrombocytopenia and eczema is often
    referred to as:

a. DiGeorge syndrome
b. Bruton agammaglobulinemia
c. ataxia telangiectasia
d. Wiskott-Aldrich syndrome

A

d. Wiskott-Aldrich syndrome

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3
Q
  1. Which of the following has been associated with patients who have homozygous C3 deficiency?

a. undetectable hemolytic complement activity in the serum
b. systemic lupus erythematosus
c. no detectable disease
d. a lifelong history of life-threatening infections

A

d. a lifelong history of life-threatening infections

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4
Q
  1. Hereditary deficiency of early complement components (C1, C4
    and C2) is associated with:

a. pneumococcal septicemia
b. small bowel obstruction
c. lupus erythematosus like syndrome
d. gonococcemia

A

c. lupus erythematosus like syndrome

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5
Q
  1. Hereditary deficiency of late complement components (C5, C6,
    C7 or C8) can be associated with which of the following conditions?

a. pneumococcal septicemia
b. small bowel obstruction
c. systemic lupus erythematosus
d. a systemic Neisseria infection if exposed

A

d. a systemic Neisseria infection if exposed

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6
Q
  1. Combined immunodeficiency disease with loss of muscle coordination is referred to as:

a. DiGeorge syndrome
b. Bruton agammaglobulinemia
c. ataxia telangiectasia
d. Wiskott-Aldrich syndrome

A

c. ataxia telangiectasia

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7
Q
  1. A patient with a B-cell deficiency will most likely exhibit:

a. decreased phagocytosis
b. increased bacterial infections
c. decreased complement levels
d. increased complement levels

A

b. increased bacterial infections

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8
Q
  1. A marked decrease in the CD4 lymphocytes and decrease in the
    CD4/CD ratio:

a. is diagnostic for bacterial septicemia
b. may be seen in most hereditary immunodeficiency disorders
c. is associated with a viral induced immunodeficiency
d. is only seen in patients with advanced disseminated cancer

A

c. is associated with a viral induced immunodeficiency

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9
Q
  1. A patient underwent renal transplant, receiving a kidney from an
    unrelated donor. This type of transplant is termed:

a. allograft
b. syngraft
c. autograph
d. xenograft

A

a. allograft

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10
Q
  1. Which of the following is a hyperacute reaction that is not part of
    chronic cell-mediated transplant rejection?

a. narrowing and occlusion of graft blood vessels
b. reaction of T and B cells to graft antigen
c. antibodies to MHC antigens on white cells
d. arteriosclerosis of the graft arterial wall

A

c. antibodies to MHC antigens on white cells

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11
Q
  1. Incompatibility by which of the following procedures is an absolute
    contraindication to allotransplantation?

a. MLC (mixed lymphocyte culture)
b. HLA typing
c. Rh typing
d. ABO grouping

A

d. ABO grouping

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11
Q
  1. Graft-versus-host disease is:

a. initiated by the recipient
b. a minor concern in bone marrow transplant
c. asymptomatic in most cases
d. initiated by the donor

A

d. initiated by the donor

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12
Q
  1. Bone marrow transplant donors and their recipients should be preferentially matched for which antigen system(s)?

a. ABO-Rh
b. HLA
c. CD4/CD8
d. Pla1

A

b. HLA

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13
Q
  1. A 28-year-old man is seen by a physician because of several months of intermittent low back pain. The patient’s symptoms are suggestive of ankylosing spondylitis. Which of the following laboratory studies would support this diagnosis?

a. a decreased synovial fluid CH50 level
b. low serum CH50 level
c. positive HLA-B27 antigen test
d. rheumatoid factor in the synovial fluid

A

c. positive HLA-B27 antigen test

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14
Q
  1. HLA-B8 antigen has been associated with an increased incidence
    of which of the following pairs of diseases?

a. ankylosing spondylitis and myasthenia gravis
b. celiac disease and ankylosing spondylitis
c. myasthenia gravis and celiac disease
d. Reiter disease and multiple sclerosis

A

c. myasthenia gravis and celiac disease

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14
Q
  1. HLA typing of a family yields the results in this table:

On the basis of these genotypes, predict the possibility of ankylosing spondylitis in this percentage of their children.

a. 25% of their children
b. 50% of their children
c. 75% of their children
d. 100% of their children

A

b. 50% of their children

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15
Q
  1. Alpha-fetoprotein, an oncofetal antigen, is least likely to be found
    in:

a. pregnancy
b. hepatocellular carcinoma
c. cirrhosis
d. breast carcinoma

A

d. breast carcinoma

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16
Q
  1. Immunoediting describes the theory that our immune system prevents many cancers. Which of the following is not one of its 3 phases (called the 3’e’s)?

a. efficiency
b. equilibrium
c. escape
d. elimination

A

a. efficiency

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16
Q
  1. Tumor-associated transplantation antigens (TAAs) are not found in:

a. fetal cells
b. tumor cells
c. bacterial cells
d. viral cells

A

c. bacterial cells

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17
Q
  1. The presence of HBsAg, anti-HBc and often HBeAg is characteristic of:

a. early acute phase HBV hepatitis
b. early convalescent phase HBV hepatitis
c. recovery phase of acute HBV hepatitis
d. past HBV infection

A

a. early acute phase HBV hepatitis

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18
Q
  1. From the test results in the table, it can be concluded that patient #3 has:

a. recent acute hepatitis A
b. acute hepatitis B
c. acute hepatitis C (non-A/non-B hepatitis)
d. chronic hepatitis B

A

b. acute hepatitis B

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19
Q
  1. The disappearance of HBsAg and HBeAg, the persistence of anti-HBc, the appearance of anti-HBs, and often of anti-HBe indicate:

a. early acute HBV hepatitis
b. early convalescent phase HBV hepatitis
c. recovery phase of acute HBV hepatitis
d. carrier state of acute HBV hepatitis

A

c. recovery phase of acute HBV hepatitis

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20
Q
  1. An example of a live attenuated vaccine used for human immunization is:

a. rabies
b. tetanus
c. hepatitis B
d. measles

A

d. measles

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21
Q
  1. What assay would confirm the immune status of hepatitis B Virus?

a. HBsAg
b. anti-HBs
c. IgM anti-HBcAg
d. hepatitis C Ag

A

b. anti-HBs

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22
Q
  1. The following procedure has been routinely used for detection of hepatitis B surface antigen (HBsAg) because of its high level of sensitivity:

a. hemagglutination
b. counterimmunoelectrophoresis
c. radial immunodiffusion
d. ELISA

A

d. ELISA

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23
Q
  1. Which of the following is the best indicator of an acute infection with the hepatitis A virus?

a. the presence of IgG antibodies to hepatitis A virus
b. the presence of IgM antibodies to hepatitis A virus
c. a sharp decline in the level of IgG antibodies to hepatitis A
virus
d. a rise in both Ig

A

b. the presence of IgM antibodies to hepatitis A virus

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24
Q
  1. Which serological marker of HBV (hepatitis B virus) infection indicates recovery and immunity?

a. viral DNA polymerase
b. HBe antigen
c. anti-HBs
d. HBsAg

A

c. anti-HBs

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25
Q
  1. The profile that matches the typical test profile for chronic active hepatitis due to hepatitis B virus is:

a. profile a
b. profile b
c. profile c
d. profile d

A

a. profile a

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26
Q
  1. A 26-year-old nurse developed fatigue, a low-grade fever, polyarthritis and urticaria. She had cared for a patient with hepatitis 2 months earlier. Which of the following findings are likely to be observed in this nurse?

a. a negative hepatitis B surface antigen test
b. elevated AST and ALT levels
c. a positive rheumatoid factor
d. a positive Monospot™ test

A

b. elevated AST and ALT levels

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27
Q
  1. The classic antibody response pattern following infection with hepatitis A is:

a. increase in IgM antibody→decrease in IgM antibody→increase in IgG antibody
b. detectable presence of IgG antibody only
c. detectable presence of IgM antibody only
d. decrease in IgM antibody-increase in IgG antibody of the IgG3 subtype

A

a. increase in IgM antibody→decrease in IgM antibody→increase in IgG antibody

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28
Q
  1. The 20 nm spheres and filamentous structures of HBV are:

a. infectious
b. circulating aggregates of HBcAg
c. circulating aggregates of HBsAg
d. highly infectious when present in great abundance

A

c. circulating aggregates of HBsAg

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28
Q
  1. The enzyme-linked immunosorbent assay (ELISA) technique for the detection of HBAg:

a. requires radiolabeled Clq
b. is quantitated by degree of fluorescence
c. uses anti-HBs linked to horseradish peroxidase
d. uses beads coated with HBsAg

A

c. uses anti-HBs linked to horseradish peroxidase

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29
Q
  1. The antigen marker most closely associated with transmissibility of HBV infection is:

a. HBsAg
b. HBeAg
c. HBcAg
d. HBV

A

b. HBeAg

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30
Q
  1. Chronic carriers of HBV:

a. have chronic symptoms of hepatitis
b. continue to carry HBV
c. do not transmit infection
d. carry HBV but are not infectious

A

b. continue to carry HBV

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31
Q
  1. Which laboratory technique is most frequently used to diagnose and follow the course of therapy of patients with secondary syphilis?

a. flocculation
b. precipitation
c. complement fixation
d. indirect immunofluorescence

A

a. flocculation

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31
Q
  1. The initial immune response following fetal infection with rubella is
    the production of which class(es) of antibodies?

a. IgG
b. IgA
c. IgM
d. both IgG and IgA

A

c. IgM

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32
Q
  1. Hepatitis C Differs from hepatitis A because it:

a. has a highly stable incubation period
b. is associated with a high incidence of icteric hepatitis
c. is associated with a high incidence of the chronic carrier state
d. is seldom implicated in cases of posttransfusion hepatitis

A

c. is associated with a high incidence of the chronic carrier state

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33
Q
  1. Which of the following is true of the first stage of infection with Borrelia burgdorferi?

a. a generalized rash develops within 4-6 hours of a bite by a deer tick
b. the patient may be asymptomatic except for the rash
c. once developed, the rash persists for 7-10 days
d. serologic testing is often positive within 1 week after the tick bite

A

b. the patient may be asymptomatic except for the rash

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33
Q
  1. Which of the following is characteristic of the second stage of
    infection with Borrelia burgdorferi?

a. spread to brain and spinal cord via cerebrospinal fluid
b. spread to multiple organ systems via the bloodstream
c. 3-4 week latency after tick bite
d. involvement of the liver, gallbladder, and pancreas

A

b. spread to multiple organ systems via the bloodstream

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34
Q
  1. Which of the following is characteristic of the late stage of
    infection with Borrelia burgdorferi?

a. spread to brain and spinal cord via cerebrospinal fluid
b. development in patients refractory to antibiotic therapy
c. arthritis, peripheral neuropathy, or encephalomyelitis
d. resistance to antibiotic therapy

A

c. arthritis, peripheral neuropathy, or encephalomyelitis

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35
Q
  1. Which of the following is consistent with CDC recommendations for confirmation of infection with Borrelia burgdorferi?

a. perform screening EAl with commercially-prepared antibody
coated slides
b. if asymptomatic but screening positive, perform both gIM and IgG western blot
c. confirm diagnosis if 1 of 3 critical IgM bands reactive on nitrocellulose strip
d. confirm diagnosis if half of the 10 critical IgG bands reactive on nitrocellulose strip

A

d. confirm diagnosis if half of the 10 critical IgG bands reactive on nitrocellulose strip

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36
Q
  1. Which of the following statements is most accurate regarding polymerase chain reaction (PCR) confirmation of infection with Borrelia burgdorferi?

a. PCR detects specific Borrelia antibodies
b. no cross-reactivity issues exist with PCR because of its specificity
c. PCR is recommended to routine positive screening tests
d. PCR can utilize either a fluorescent or enzyme marker

A

c. PCR is recommended to routine positive screening tests

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37
Q
  1. Purified protein derivative is used to assess the presence of infection with Mycobacterium tuberculosis in the:

a. Mantoux test
b. RAST test
c. serum sickness test
d. Laurell test

A

a. Mantoux test

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38
Q
  1. The Mantoux test for Mycobacterium tuberculosis is based on a:
    a. Type III hypersensitivity reaction
    b. Type lI hypersensitivity reaction
    c. Type I hypersensitivity reaction
    d. Type IV hypersensitivity reaction
A

d. Type IV hypersensitivity reaction

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39
Q
  1. The Mantoux skin test to identify infection with Mycobacterium
    tuberculosis is:

a. a cell-mediated response
b. an IgG response
c. an IgE response
d. an IgM response

A

a. a cell-mediated response

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40
Q

181.The Quanti-FERON-TB Gold In-Tube (QFT-GIT) test to support diagnosis of latent tuberculosis measures release of interferon gamma (IFNy) by:

a. T cells
b. macrophages
c. neutrophils
d. B cells

A

a. T cells

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41
Q
  1. Anti-nuclear antibody tests are performed to help diagnose:

a. acute leukemia
b. lupus erythematosus
c. hemolytic anemia
d. Crohn disease

A

b. lupus erythematosus

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41
Q
  1. A cytokine that is classically associated with Th1 cells is:

a. interleukin-4
b. interferon gamma
c. interleukin-5
d. interferon alpha

A

b. interferon gamma

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42
Q
  1. In the anti-double-stranded DNA procedure, the substrate most commonly utilized is:

a. rat stomach tissue
b. mouse kidney tissue
c. Crithidia luciliae
d. Toxoplasma gondii

A

c. Crithidia luciliae

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43
Q
  1. Which of the ANA patterns shown in this image would be associated with high titers of antibodies to the Sm antigen?

a. image A
b. image B
c. image C
d. image D

A

c. image C

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44
Q
  1. Sera to be tested for IFA-ANA 6 days after drawing is best stored at:

a. room temperature
b. 5°C +2°C
c. -70°C in a constant temperature freezer
d. -20°C in a frost-free self-defrosting freezer

A

b. 5°C +2°C

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45
Q
  1. Antibodies directed at native DNA are most frequently associated with which pattern of fluorescence in the IFA-ANA test?

a. rim
b. diffuse
c. speckled
d. centromere

A

a. rim

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46
Q
  1. The technologist observes apparent homogenous staining of the nucleus of interphase cells while performing an IFA-ANA, as well as staining of the chromosomes in mitotic cells. This result is:

a. indicative of 2 antibodies, which should be separately
reported after titration
b. expected for anti-DNA antibodies
c. inconsistent; the test should be reported with new reagent
d. expected for anti-centromere antibodies

A

b. expected for anti-DNA antibodies

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47
Q
  1. The result of an anti-nuclear antibody test is a titer of 1:320 with a
    peripheral pattern. Which set of data best correlates with these results?

a. anti-dsDNA titer 1:80, and a high titer of antibodies to Sm
b. anti-mitochondrial antibody titer 1:160, and antibodies to RNP
c. anti-Scl-70, and antibodies to single-stranded DNA
d. high titers of anti-SS-A and anti-SS-B

A

a. anti-dsDNA titer 1:80, and a high titer of antibodies to Sm

48
Q
  1. A positive ANA with the pattern of anti-centromere antibodies is most frequently seen in patients with:

a. rheumatoid arthritis
b. systemic lupus erythematosus
c. CREST syndrome
d. Sjögren syndrome

A

c. CREST syndrome

49
Q
  1. In the indirect fluorescent anti-nuclear antibody test, a homogenous pattern indicates the presence of antibody to:

a. RNP
b. Sm
c. RNA
d. DNA

A

d. DNA

50
Q
  1. In the indirect fluorescent anti-nuclear antibody test, a speckled
    pattern may indicate the presence of antibody to:

a. histone
b. Sm
c. RNA
d. DNA

A

b. Sm

51
Q
  1. Anti-extractable nuclear antigens are most likely associated with which of the following anti-nuclear antibody immunofluorescent patterns?

a. speckled
b. rim
c. diffuse
d. nucleolar

A

a. speckled

51
Q
  1. Anti-RNA antibodies are often present in individuals having an
    anti-nuclear antibody immunofluorescent pattern that is:

a. speckled
b. rim
c. diffuse
d. nucleolar

A

d. nucleolar

52
Q
  1. Which of the following is true of Hashimoto thyroiditis?

a. it is more common in male patients
b. it is also known as chronic lymphocytic thyroiditis
c. anti-thyroid-stimulating hormone receptor (TRAb) is usually present
d. the goiter is firm rather than rubbery

A

b. it is also known as chronic lymphocytic thyroiditis

53
Q
  1. In an anti-nuclear antibody indirect immunofluorescence test, a sample of patient serum shows a positive, speckled pattern. Which would be the most appropriate additional test to perform?

a. anti-mitochondrial antibody
b. immunoglobulin quantitation
c. screen for Sm and RNP antibodies
d. anti-DNA antibody using Crithidia luciliae

A

c. screen for Sm and RNP antibodies

54
Q
  1. In the anti-nuclear antibody test, what are the fixed HEp-2 cells?

a. unlabeled antigen
b. labeled antigen
c. labeled antiglobulin
d. unlabeled antiglobulin

A

a. unlabeled antigen

55
Q
  1. Which of the following is true of Graves disease?

a. it is more common in male patients
b. it is also known as chronic lymphocytic thyroiditis
c. the presence of anti-thyroid-stimulating hormone receptor
(TRAb) is diagnostic
d. the goiter is firm rather than rubbery

A

d. the goiter is firm rather than rubbery

56
Q
  1. Rheumatoid factors are immunoglobulins with specificity for
    allotypic determinants located on the:

a. Fc fragment of IgG
b. Fab fragment of IgG
c. J chain of IgM
d. secretory of component of IgA

A

a. Fc fragment of IgG

57
Q
  1. Which of the following thyroid antibodies causes hyperthyroidism
    by binding to the TSH receptor?

a. anti-thyroglobulin (Tg)
b. anti-thyroperoxidase (TPO)
c. anti-thyroid-stimulating hormone receptor (TRAb)
d. anti-thyroid-stimulating hormone (TSH)

A

c. anti-thyroid-stimulating hormone receptor (TRAb)

58
Q
  1. Rheumatoid factor in a patient’s serum may cause a false:

a. positive test for the detection of IgM class antibodies
b. negative test for the detection of IgM class antibodies
c. positive test for the detection of IgG class antibodies
d. negative test for the detection of IgG class antibodies

A

a. positive test for the detection of IgM class antibodies

59
Q
  1. Rheumatoid factors are defined as:

a. antigens found in the sera of patients with rheumatoid arthritis
b. identical to the rheumatoid arthritis precipitin
c. autoantibodies with specificity for the Fc portion of the immunoglobulin (IgG) molecule
d. capable of forming circulating immune complexes only when
IgM-type autoantibody is present

A

c. autoantibodies with specificity for the Fc portion of the immunoglobulin (IgG) molecule

60
Q
  1. False-positive rheumatoid factor in agglutination and nephelometric methods can be due to elevated levels of:

a. cryoglobulin
b. histidine-rich-glycoprotein
c. aspartame
d. C1q

A

d. C1q

61
Q
  1. In the direct immunofluorescence assay for Legionella pneumophila, patient sample affixed to the slide may be detected with:

a. primary antigen with fluorescent conjugate
b. primary antibody with fluorescent conjugate
c. secondary antigen with fluorescent conjugate
d. secondary antibody with fluorescent conjugate

A

b. primary antibody with fluorescent conjugate

61
Q
  1. Which of the following is not commonly associated with the effects
    of rheumatoid factor?

a. joint inflammation
b. immune complex deposition
c. capillary endothelial space widening
d. complement inhibition

A

d. complement inhibition

61
Q
  1. An agglutination test wherein the antigen is a natural component of the infectious entity is a(n):

a. indirect agglutination procedure
b. direct agglutination procedure
c. passive agglutination procedure
d. reverse passive agglutination procedure

A

b. direct agglutination procedure

62
Q
  1. Rheumatoid factor is most often of which of the following classes:

a. lgE
b. IgA
c. IgM
d. IgG

A

c. IgM

63
Q
  1. Rheumatoid factor consists of antibodies that bind the:

a. Fc portion of the IgG molecule
b. Fab portion of the IgG molecule
c. Fc portion of the IgM molecule
d. Fab portion of the IgM molecule

A

a. Fc portion of the IgG molecule

64
Q
  1. A suspected anthrax lesion is submitted to the lab for preparation and testing. The test of choice to perform on this sample is:

a. capture immunoassay
b. indirect immunoassay
c. direct immunoassay
d. sandwich immunoassay

A

c. direct immunoassay

65
Q
  1. The specificity of an immunoassay is determined by the:

a. label used on the antigen
b. method used to separate the bound from free antigen
c. antibody used in the assay
d. concentration of unlabeled antigen

A

c. antibody used in the assay

66
Q
  1. In the indirect immunofluorescence method of antibody detection in patient serum, the labeled antibody is:

a. human anti-goat immunoglobulin
b. rheumatoid factor
c. goat anti-human immunoglobulin
d. complement

A

c. goat anti-human immunoglobulin

67
Q

213.The primary advantage of labeled immunoassays compared to unlabeled immunoassays is:

a. rapidity
b. quality
c. sensitivity
d. cost

A

c. sensitivity

67
Q
  1. A substrate is first exposed to a patient’s serum, then after washing, anti-human immunoglobulin labeled with a fluorochrome is added.

The procedure described is:

a. fluorescent quenching
b. direct fluorescence
c. indirect fluorescence
d. fluorescence inhibition

A

c. indirect fluorescence

68
Q
  1. Which of the following pairs of considerations do not pertain to
    ELISA testing?

a. competitive vs noncompetitive
b. heterogeneous vs homogeneous
c. luminescent vs fluorescent
d. radioactive vs colorimetric

A

d. radioactive vs colorimetric

69
Q
  1. A physician suspects the presence of anti-IFNy autoantibodies in a patient. A serum sample is sent to your laboratory to measure the presence or absence of anti-IFNy autoantibodies by an enzyme-immunoassay. Which of the following would be used as the detecting reagent in the kit?

a. horseradish peroxidase-conjugated recombinant human IFNy
b. horseradish peroxidase-conjugated mouse Ab to goat Ab
c. horseradish peroxidase-conjugated goat Ab to human INy
d. horseradish peroxidase-conjugated mouse Ab to human Ab

A

d. horseradish peroxidase-conjugated mouse Ab to human Ab

69
Q
  1. A classic ELISA test is performed on a sample from a 67-year-old male patient who is suspected of having ingested large amounts of drug X. The ELISA procedure is performed as follows:
  2. incubation of patient sample in antibody-coated microtiter
    plate wells
  3. plate washing
  4. addition of peroxidase-linked drug X conjugate
  5. incubation followed by plate washing
  6. addition of hydrogen peroxide
  7. evaluation of color change

Which of the following is true regarding this procedure?

a. hydrogen peroxide is the substrate
b. the conjugate contains the antibody
c. the test is homogeneous
d. the test is noncompetitive

A

a. hydrogen peroxide is the substrate

70
Q
  1. Cholesterol is added to the antigen used in flocculation tests for syphilis to:

a. destroy tissue impurities present in the alcoholic beef heart extract
b. sensitize the sheep RBCs
c. decrease specificity of the antigen
d. increase sensitivity of the antigen

A

d. increase sensitivity of the antigen

71
Q
  1. Flocculation tests for syphilis use antigen composed of:

a. Treponema pallidum
b. Reagin
c. cardiolipin and lecithin
d. charcoal

A

c. cardiolipin and lecithin

72
Q
  1. Flocculation tests for syphilis detect the presence of:

a. Reagin antibody
b. antigen
c. hemolysin
d. Forssman antigen

A

a. Reagin antibody

73
Q
  1. A serological test for syphilis that depends upon the detection of cardiolipin-lecithin-cholesterol antigen is:

a. FTA-ABS
b. RPR
c. MRAT-P
d. TPI

A

b. RPR

74
Q
  1. In the direct fluorescent antibody test for primary syphilis, spirochetes are detected by addition of labeled antibody to:

a. Treponema pallidum
b. cardiolipin
c. human immunoglobulin
d. nonpathogenic treponemes

A

a. Treponema pallidum

74
Q
  1. Biological false-positive VDRL reactions are frequently encountered in patients with:

a. lupus erythematosus
b. acquired immune deficiency syndrome (AlDS)
c. gonorrhea
d. tertiary syphilis

A

a. lupus erythematosus

74
Q
  1. The serological test for syphilis recommended for detecting antibody in cerebrospinal fluid is:

a. non-treponemal antibody
b. CSF-VDRL
c. FTA-ABS
d. MHA-TP

A

b. CSF-VDRL

75
Q
  1. In the FTA-ABS test, the presence of a beaded pattern of fluorescence along the treponeme indicates:

a. positive identification of Treponema pallidum
b. presumptive diagnosis of active syphilis
c. presence of non-treponemal antibody (NTA)
d. false-positive reaction

A

d. false-positive reaction

76
Q
  1. The air temperature throughout the serology laboratory is 20°C. How will this affect VDRL and RPR test results?

a. no effect—the acceptable test range is 20-24°C
b. weaken reactions so that false-negatives occur
c. strengthen reactions so that positive titers appear elevated
d. increase the number of false-positives from spontaneous
clumping

A

b. weaken reactions so that false-negatives occur

76
Q
  1. For diagnosis of late latent or tertiary syphilis, the most appropriate assay is:

a. RPR
b. VDRL
c. FTA-ABS
d. FTA-ABS IgM

A

c. FTA-ABS

77
Q
  1. IL-4 can stimulate B cells to produce IgE, a major contributor to:

a. Type I hypersensitivity
b. Type lI hypersensitivity
c. Type I hypersensitivity
d. Type IV hypersensitivity

A

a. Type I hypersensitivity

78
Q
  1. Cytokines involved in innate immune regulation include all but:

a. IL-6
b. IL-3
c. IL-1
d. TNF-alpha

A

b. IL-3

79
Q
  1. Multiplex bead assays for the detection of cytokines are efficient
    quantifiers of numerous cytokines at one time. One complication of
    such testing is:

a. the cross-reactivity of fluorescent probes
b. the short half-life of certain cytokines
c. the lack of test sensitivity
d. inadequate cytokine-specific antibodies

A

b. the short half-life of certain cytokines

80
Q
  1. The procedure for compatibility testing in organ transplant medicine is very similar for the donor and the recipient. One additional procedure that the recipient must undergo that is not relevant to donor testing is:

a. ABO typing
b. HLA typing
c. CMV testing
d. anti-HLA antibody testing

A

d. anti-HLA antibody testing

81
Q
  1. PCR is extremely sensitive, but testing may be complicated by:

a. an inability to detect nucleic acids from nonviable organisms
b. poor quality amplification
c. contamination of samples yielding false-positive results
d. lack of specificity

A

c. contamination of samples yielding false-positive results

82
Q
  1. Methods of target amplification in molecular testing include all but:

a. reverse transcriptase-based amplification
b. strand displacement amplification
c. signal amplification
d. primer amplification

A

d. primer amplification

83
Q
  1. What type of short read files with quality scores are used for storing next generation sequencing read data?

a. FASTA
b. FASTQ
c. RRBS
d. WGBS

A

b. FASTQ

84
Q
  1. In dideoxy chain termination sequencing (Sanger method), what does a heterozygous nucleotide position look like on an electropherogram?

a. 1 peak twice the height of those around it
b. 2 peaks in the same position, one twice the height of the
other
c. 2 peaks of equal height at the same position
d. 3 peaks of equal height at the same position

A

c. 2 peaks of equal height at the same position

85
Q
  1. What is the sequence of the DNA shown on this pyrogram?

a. allele 1: ATACGTGCC allele 2: ATACGTGCC
b. allele 1: ATACGTGCC allele 2: ATACGTACC
c. allele 1: ATACGTGAGC allele 2: ATACGTGAGC
d. allele 1: ATACGTGACC allele 2: ATACGTGACC

A

b. allele 1: ATACGTGCC allele 2: ATACGTACC

86
Q
  1. Which condition has the highest stringency for DNA probe hybridization?

a. low temperature, low salt concentration
b. high temperature, low salt concentration
c. high temperature, high salt concentration
d. low temperature, high salt concentration

A

b. high temperature, low salt concentration

87
Q
  1. Anti-phospholipid antibodies associated with autoimmune disorders tend to have immunoglobulin (IgG) that belongs to which of the following subclasses?

a. IgG1 and IgG3
b. IgG2 and IgG4
c. IgG1 and IgG4
d. IgG2 and IgG3

A

b. IgG2 and IgG4

88
Q
  1. The most commonly used serological indicator of recent streptococcal infection is the antibody to:

a. streptolysin O
b. hyaluronidase
c. NADnase
d. DNA

A

a. streptolysin O

89
Q
  1. The IF staining pattern on ethanol-fixed leukocytes slides shows a perinuclear or nuclear staining pattern. This pattern is typically due to

a. C-ANCA
b. LKM
c. P-ANCA
d. GBM

A

c. P-ANCA

90
Q
  1. A heterophile antigen is best described as?

a. an auto-antigen
b. existing in an unrelated animal
c. resulting from an amnestic response
d. an adjuvant to increase immune response

A

b. existing in an unrelated animal

91
Q
  1. In laser flow cytometry, applying a voltage potential to sample droplets as they stream past the light beam and using charged deflector plates results in:

a. an emission of red fluorescence from cells labeled with fluorescein isothiocyanate
b. an emission of green fluorescence from cells labeled with rhodamine
c. a 90° light scatter related to cell size
d. the separation of cells into subpopulations based on their charge

A

d. the separation of cells into subpopulations based on their charge

92
Q
  1. What should be adjusted to make sure emission of fluorescence from a single fluorophore does not bleed into multiple channels?

a. compensation
b. threshold
c. voltage
d. fluid speed

A

a. compensation

93
Q
  1. What does light emitted as FSC measure?

a. cell granularity/complexity
b. cell size
c. cell surface marker fluorescence
d. nucleic acid marker fluorescence

A

b. cell size

94
Q
  1. What type of biological sample is best measured by flow cytometry?

a. single cell suspension
b. a piece of tissue
c. intact BM core biopsy
d. plasma

A

a. single cell suspension

95
Q
  1. The process of centering the sample core within the sheath fluid is
    known as:

a. acoustic focusing
b. hydrodynamic focusing
c. liquid focusing
d. isoelectric focusing

A

b. hydrodynamic focusing

96
Q
  1. To which filters do these definitions correspond: 1) transmit light in the specified wavelength, 2) transmit light equal to or longer than specified wavelength, 3) transmit light equal to or shorter than specified wavelength

a. longpass, shortpass, bandpass
b. shortpass, bandpass, longpass
c. bandpass, longpass, shortpass
d. bandpass, shortpass, longpass

A

c. bandpass, longpass, shortpass

97
Q
  1. The electronic signal produced by the detectors is proportional to:

a. the amount of light striking them
b. the speed of fluid flow
c. the presence of clumps in the sample
d. the viscosity of the fluid

A

a. the amount of light striking them

97
Q
  1. A 25-year-old woman is seen by a physician because of Raynaud phenomenon, myalgias, arthralgias and difficulty in swallowing. There is no evidence of renal disease. An ANA titer is 1:5120 with a speckled pattern with mitotic cells. Which of the following are also likely to be found in this patient?

a. high-level DNA antibody and a low CH50 level
b. high-level Sm antibody
c. high-titer rheumatoid factor
d. high-level ribonucleoprotein (RNP) antibody

A

d. high-level ribonucleoprotein (RNP) antibody

98
Q
  1. In assessing the usefulness of a new laboratory test, sensitivity is defined as the percentage of:

a. positive specimens correctly identified
b. false-positive specimens
c. negative specimens correctly identified
d. false-negative specimens

A

a. positive specimens correctly identified

98
Q
  1. Which of the following is most useful in establishing a diagnosis in
    the convalescence phase of a viral infection?

a. slide culture
b. serological techniques
c. shell vial
d. culture on McCoy media

A

b. serological techniques

99
Q
  1. A 16-year-old boy with infectious mononucleosis has a cold agglutinin titer of 1:2000. An important consideration of this antibody’s
    clinical relevance is the:

a. thermal range
b. titer at 4°C
c. specificity
d. light chain type

A

a. thermal range

100
Q

252.The serum hemolytic complement level (CH50):

a. is a measure of total complement activity
b. provides the same information as a serum factor B level
c. is detectable when any component of the classical system is congenitally absent
d. can be calculated from the serum concentrations of the individual components

A

a. is a measure of total complement activity

101
Q
  1. A patient’s serum is being analyzed in a sandwich assay. This patient has received mouse monoclonal antibody therapy and shows a false-positive reaction in the sandwich assay. This is due to:

a. the mouse antibody in the patient’s serum reacting to the antigen
b. the presence of human anti-mouse antibody activity
c. antibody to a mouse virus
d. production of a monoclonal gammopathy of unknown significance after the antibody treatment

A

b. the presence of human anti-mouse antibody activity

102
Q
  1. Calculate the absolute count for B lymphocytes from the flow cytometric data in this table:

a. 1072
b. 2679
c. 3572
d. 6251

A

a. 1072

103
Q
  1. In flow cytometry, labeled cells:

a. scatter the light and absorb fluorescence
b. absorb fluorescence and emit electronic impulses
c. scatter the light and emit fluorescence
d. absorb both fluorescence and light

A

c. scatter the light and emit fluorescence

103
Q
  1. The total number of T cells expected from this data from a
    peripheral blood sample is:

a. 20
b. 1000
c. 2000
d. 2500

A

b. 1000

104
Q
  1. A peripheral blood total leukocyte count is 10.0 × 10^3/uL (10.0 x 10^9/L). The differential reveals 55% neutrophils, 2% eosinophils, 40% lymphocytes and 3% monocytes. Assuming a lymphocyte recovery of 85-95%, what is the expected number of T cells in a normal individual?

a. 750/uL
b. 2500/uL
c. 4000/uL
d. 8000/uL

A

b. 2500/uL

105
Q
  1. Given this hematologic data, calculate the absolute CD4:

a. 40
b. 60
c. 400
d. 750

A

b. 60

106
Q
  1. Which is the correct interpretation of this hematologic data?

a. CD4% and absolute CD4 count are normal
b. consistent with an intact immune system
c. consistent with a viral infection such as HIV
d. technical error

A

c. consistent with a viral infection such as HIV

107
Q
  1. A patient’s abnormal lymphocytes are positive for CD2 antigen, lack C3 receptors, and are negative for surface immunoglobulin. This can be classified as a disorder of:

a. T cells
b. B cells
c. monocytes
d. natural killer cells

A

a. T cells

108
Q
  1. A patient returns from a camping trip, where he vacationed for several days in a tick-endemic environment. One month after his return home, he visited his healthcare provider with complaints of fatigue, numbness and history of rash surrounding an insect bite that occurred immediately on his return home from vacation. Suspecting Lyme disease, his clinician ordered an ELISA to test for Lyme antibody, results of which were equivocal on two different tests. His health care provider then ordered follow-up testing with:

a. western blot
b. Southern blot
c. northern blot
d. eastern blot

A

a. western blot

109
Q
  1. On a follow-up visit to her healthcare provider, a young woman is
    given the results of her FTA-ABS test. She has been symptomatic for a couple of months before this visit, with fever, swollen cervical lymph nodes, fatigue, and rash affecting the palms of her hands and the soles of her feet, but she is now feeling better. Earlier test strategies that one would expect the healthcare provider or have requested should not include which of the following?

a. RPR
b. TPHA
c. VDRL
d. RAST

A

d. RAST

109
Q
  1. Hepatitis B, a disease arising from a DNA virus, is diagnosed in its acute phase via serology for HBsAg, HBcIgM and total alpha-HBc. Once a patient reaches chronic HBV infection, effectiveness of therapy may be evaluated using:

a. HBV DNA testing with real time PCR
b. alpha-HBe testing
c. alpha-HBs testing
d. IgM alpha-HBc

A

a. HBV DNA testing with real time PCR

110
Q
  1. Mumps is diagnosed by swollen salivary glands, and it spreads from the infected person to others through contact with saliva or respiratory secretions. Enzyme immunoassays (EIA) is used to detect mump-specific antibodies to confirm current infection. Which of the following results confirm mumps infection?

a. detection of gIM antibodies within 3-4 days of onset of symptoms; detection of IgG within 7-10 days and 4-fold increase in IgG between specimens collected in acute & convalescence phases
b. detection of gIM antibodies within 5 days and rash; the detection of IgG within 10-14 days apart
c. detection of IgM antibodies with acute infection; detection of 4-fold increase in IgG between acute & convalescent
d. detection of IgG at >6 months of age demonstrating post-birth infection

A

a. detection of gIM antibodies within 3-4 days of onset of symptoms; detection of IgG within 7-10 days and 4-fold increase in IgG between specimens collected in acute & convalescence phases

110
Q
  1. A 37-year-old male presents to his health care provider with a recent onset of fatigue, fever, myalgias, nausea, vomiting and diarrhea, complaining that he feels like he is suffering from unremitting flu. Visible on his right forearm is a tattoo that he states he had since age 17. In the last 2 days, he had noted onset of right upper quadrant
    abdominal pain and dark-colored urine. His diagnosis is most likely:

a. hepatitis B
b. hepatitis D
c. hepatitis C
d. hepatitis A

A

c. hepatitis C

111
Q
  1. A 17-year-old female presents to her health care provider with symptoms of sore throat, cervical lymphadenopathy, fever, fatigue, and
    myalgias. Which of the following should be excluded from her differential diagnosis?

a. group A strep pharyngitis
b. infectious mononucleosis
c. human immunodeficiency virus
d. rotavirus

A

d. rotavirus

112
Q
  1. Which of the following best correlates with a diagnosis of systemic lupus erythematosus (SLE)?

a. HEp-2 substrate IFA homogeneous pattern and antibodies to dsDNA
b. HEp-2 substrate IFA centromere pattern and antibodies to centromere B
c. HEp-2 substrate IFA speckled pattern and antibodies to Scl-70
d. HEp-2 substrate IFA speckled pattern and antibodies to SSB

A

a. HEp-2 substrate IFA homogeneous pattern and antibodies to dsDNA

113
Q
  1. An HLA allele that is classically associated with ankylosing spondylitis is:

a. HLA-DQ2
b. HLA-B27
c. HLA-DQ8
d. HLA-DR2

A

b. HLA-B27

114
Q
  1. A 54-year-old female previous smoker presents with a recent history of fever, swollen joints, and morning stiffness. Laboratory results indicate elevated C-reactive protein, positive cyclic citrullinated peptide of 205 units (cut-off: 20 units), speckled ANA pattern (titer 1:320), and negative rheumatoid factor. What is the most likely diagnosis?

a. reactive arthritis
b. rheumatoid arthritis
c. systemic sclerosis
d. Sjögren syndrome

A

b. rheumatoid arthritis

SEROLOGY MTAP 1 (8 decks)

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