BOC Study Guide PART 2 (CHAPTER REVIEW) Flashcards
- 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
c. there are decreased to absent concentrations of
immunoglobulins
- Immunodeficiency with thrombocytopenia and eczema is often
referred to as:
a. DiGeorge syndrome
b. Bruton agammaglobulinemia
c. ataxia telangiectasia
d. Wiskott-Aldrich syndrome
d. Wiskott-Aldrich syndrome
- 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
d. a lifelong history of life-threatening infections
- 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
c. lupus erythematosus like syndrome
- 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
d. a systemic Neisseria infection if exposed
- 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
c. ataxia telangiectasia
- 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
b. increased bacterial infections
- 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
c. is associated with a viral induced immunodeficiency
- 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. allograft
- 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
c. antibodies to MHC antigens on white cells
- 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
d. ABO grouping
- 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
d. initiated by the donor
- 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
b. HLA
- 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
c. positive HLA-B27 antigen test
- 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
c. myasthenia gravis and celiac disease
- 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
b. 50% of their children
- Alpha-fetoprotein, an oncofetal antigen, is least likely to be found
in:
a. pregnancy
b. hepatocellular carcinoma
c. cirrhosis
d. breast carcinoma
d. breast carcinoma
- 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. efficiency
- Tumor-associated transplantation antigens (TAAs) are not found in:
a. fetal cells
b. tumor cells
c. bacterial cells
d. viral cells
c. bacterial cells
- 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. early acute phase HBV hepatitis
- 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
b. acute hepatitis B
- 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
c. recovery phase of acute HBV hepatitis
- An example of a live attenuated vaccine used for human immunization is:
a. rabies
b. tetanus
c. hepatitis B
d. measles
d. measles
- What assay would confirm the immune status of hepatitis B Virus?
a. HBsAg
b. anti-HBs
c. IgM anti-HBcAg
d. hepatitis C Ag
b. anti-HBs
- 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
d. ELISA
- 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
b. the presence of IgM antibodies to hepatitis A virus
- 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
c. anti-HBs
- 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. profile a
- 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
b. elevated AST and ALT levels
- 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. increase in IgM antibody→decrease in IgM antibody→increase in IgG antibody
- 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
c. circulating aggregates of HBsAg
- 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
c. uses anti-HBs linked to horseradish peroxidase
- The antigen marker most closely associated with transmissibility of HBV infection is:
a. HBsAg
b. HBeAg
c. HBcAg
d. HBV
b. HBeAg
- 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
b. continue to carry HBV
- 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. flocculation
- 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
c. IgM
- 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
c. is associated with a high incidence of the chronic carrier state
- 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
b. the patient may be asymptomatic except for the rash
- 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
b. spread to multiple organ systems via the bloodstream
- 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
c. arthritis, peripheral neuropathy, or encephalomyelitis
- 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
d. confirm diagnosis if half of the 10 critical IgG bands reactive on nitrocellulose strip
- 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
c. PCR is recommended to routine positive screening tests
- 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. Mantoux test
- 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
d. Type IV hypersensitivity reaction
- 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 cell-mediated response
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. T cells
- Anti-nuclear antibody tests are performed to help diagnose:
a. acute leukemia
b. lupus erythematosus
c. hemolytic anemia
d. Crohn disease
b. lupus erythematosus
- A cytokine that is classically associated with Th1 cells is:
a. interleukin-4
b. interferon gamma
c. interleukin-5
d. interferon alpha
b. interferon gamma
- 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
c. Crithidia luciliae
- 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
c. image C
- 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
b. 5°C +2°C
- 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. rim
- 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
b. expected for anti-DNA antibodies