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BOC study (harr book) > chemistry externship - immunology 3.1-3.2 > Flashcards

chemistry externship - immunology 3.1-3.2 Flashcards

1
Q

from the following, identiy a specific component of the adaptive immune system that is formed in response to antigenic stimulation
A. lysozyme
B. complement
C. commensal organisms
D. immunoglobulin (Ig)

A

D. Ig

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2
Q

which two organs are considered the primary lymphoid organs in which immunocompetent cells originate and mature
A. thyroid and peyer pathes
B. thymus and bone marrow
C. spleen and mucosal-associated lymphoid tissue (malt)
D. lymph nodes and thoraic duct

A

B. thymus and bone marrow

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3
Q

what type of B cells is formed after antigen stimulation
A. plasma cells and memory B cells
B. mature B cells
C. antigen dependent B cells
D. receptor activated B cells

A

A. plasma cells and memory B cells

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4
Q

T cells travel from BM to the thymus for maturation. hat is the correct order of the maturation sequence for T cells in the thymus
A. BM to the cortex; after thymic education, released back to peripheral circulation
B. maturation and selection occur in the cortex; migration to the medulla’ release of mature T cells to secondary lymphoid organs
C. storage in either the cortex or medulla; release of T cells into the peripheral circulation
D. activation and selection occur in the medulla; mature T cells are stored in the cortex until activated by antigen

A

B. maturation and selection occur in the cortex; migration to the medulla’ release of mature T cells to secondary lymphoid organs

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5
Q

which cluster of differentiation (CD) marker is the most specific for identifying marker for mature T cells
A. 1
B. 2
C. 3
D. 4 or 8

A

C. C3
- early developed to differentiated from lymphocytes

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6
Q

which markers are found on mture, peripheral helper T cells
A. 1, 2, 4
B. 2, 3, 8
C. 1, 3, 4
D. 2, 3, 4

A

D.

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7
Q

which T cells express CD8 marker and act specifically to kill tumors or virally infected cells
A, helper T cells
B. suppressor T cells
C. cytotoxic T cells
D. regulator T cells

A

C. Tc cells
- recognize MCH1 in association with viral antignes, and HLAs of graft rejection (foreign recognition)

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8
Q

how are Tc cells and natural killer cells similar
A. require antibody to be present
B. effective against virally infected cells
C. recognize antigen in association with human leukocyte antigen (HLA) class 2 markers
D. do not bind to infected cells

A

B. effected against virally infected cells

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9
Q

what is the name of the process by which phagocytic cells are attracted to a substance such as a bacterial peptide
A. diapedesis
B, degranulation
C. chemotaxis
D, phagocytosis

A

C. chemotaxis
- taxis = taxi = move

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10
Q

all of the followng are immunologic funcitons of complement except
A.induction of an antiviral state
B. opzonization
C. chemotaxis
D. anaphylatoxin formation

A

A.induction of an antiviral state
- antiviral state is a function of interferons

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11
Q

which complement component is found in both classic and alternative pathways
A. C1
B. C4
C. factor D
D. C3

A

D C3

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12
Q

which Ig helps initiate the classici complement pathway
A. IgA and IgD
B. IgM only
C. IgG and IgM
D. IgG only

A

C. IgG and IgM

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13
Q

how is complement activity destroyed in vitro
A. heating serum at 56C for 30 minutes
B. keeping serum at room temperature of 22C for 1 hour
C. heating serum at 37 for 45 minutes
D. freezing serum at 0C for 24 hours

A

A. heating serum at 56C for 30 minutes

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14
Q

what is the purpose of C3a, C4a and C5a the split products of the complement cascade
A. to bind with specific membrane receptors of lymphocytes and cause release of cytotoxic substances
B. to cause increased vascular permeability, contraction of smooth muscle, and release of histamine from basophils
C. to bind with membrane receptors of macrophages to facilitate phagocytosis and the removal of debris and foreign substances
D. to regulate and degrade membrane cofactor protein after activation by C3 convertase

A

B. to cause increased vascular permeability, contraction of smooth muscle, and release of histamine from basophils

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15
Q

which region of teh Ig molecule can bind antigen
A. Fab
B. Fc
C. constant light
D. constant heaby

A

A. Fab
- stands for fragment antigen binding

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16
Q

which region determines whether an Ig molecule can fix compliment t
A. variable heavy
B. constant heavy
C. variable light
D. constant light

A

B. constant heavy

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17
Q

which Ig class(es) has (have) a J chain
A. IgM
B. IgE and IgG
C. IgM and surface IgA
D. IgG3 and IgA

A

C. IgM and surface IgA
- J chain joins individual molecules together
-> IgM to be pentamer, IgA two molecule joining

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18
Q

which Ig appears first in the primary immune response
A. IgG
B. IgM
C. IgA
D. IgE

A

B. IgM

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19
Q

which immunoglobulin appears in highest titer in the secondary response
A. IgG
B. IgM
C. IgA
D. IgE

A

A. IgG

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20
Q

which Ig can cross the placenta
A. IgG
B. IgM
C. IgA
D. IgE

A

A. IgG

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21
Q

whic Ig cross-links mast cells to relase histamine
A. IgG
B. IgM
C. IgA
D. IgE

A

D, IgE

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22
Q

all of the following are fucntions of Igs except
A. neutralizing toxic substances
B. facilitating phagocytosis through opsonization
C. interacting with Tc cells to lyse viruses
D combining with complement to destroy cellular antigens

A

C. interacting with Tc cells to lyse viruses
- Tc cells lyse virally infected cells directly without need for Igs

23
Q

which of the following cell surface molecules is classified as an MHC 2 antigen
A. HLA-A
B. B
C. C
D. Dr

A

D. DR

24
Q

which MHC class of molecule is necessary for antigen recognition by CD4 positive T cells
A. 1
B. 2
C. 3
no MCH molecule is necessary for atnigen recognition

A

B. MHC II
- exressed on macrophages, monos and B cells that hold antigen on the surface for helper cells to recognize

25
Q

which of the following are products of HLA class 3 genes
A. T cell immune receptors
B. HLA-D antigens on immune cells
C. complement proteins C2, C4 and factor B
D. Ig VL region

A

C. complement proteins C2, C4 and factor B

26
Q

what molecule on the surface of mst T cells recognizes antigen
A. IgT, a our chain molecule that includes the tau heavy chain
B. MHC protein, a two chain molecule encoded by the HLA region
C. CD3 consisting of 6 different chaings
D T cell receptor consisting of two chains: alpha and beta

A

D. T cell receptor consisting of two chains: alpha and beta

27
Q

TcR is similar to Ig molecules in that it:
A. remains bound to the cell surface and is never secreted
B. contains V and C regions on each of its chains
C, binds complement
D. can cross the placenta and provide protection to a fetus

A

B. contains V and C regions on each of its chains
- TCR: T cell receptor consisting of two chains: alpha and beta
- alpha and beta chains are encoded by variable regions that rearrange
- alpha = V and J segments similar to light chain
- beta = V D and J similar to heavy chain

28
Q

toll-like receptors (TLRs) are found on which cells
A. T cells
B. dendritic cells
C. B cells
D. large granular lymphs

A

B dendritic cells
- primary antigen recognition protein of innate immune system on antigen presenting cells like dendritic cells and macrophages

29
Q

macrphages produce which of the following proteins during antigen processing
A. IL1 and IL6
B. gamma interferon
C. IL4, 5, and 10
D. complement components C1 and C3

A

A. IL1 and 6
- IL4, IL5, IL10 and gamma interferon are produced by T cells

30
Q

a superantigen bypasses the normal antigen processings stage by binding to and crosslinking
A. a protein of an Ig molecule and complete component C1
B. TLRs and an MHC class 1 molecules
C. a portion of an Ig and a portion of TcR
D. a portion of TcR and an MHC II moleuclue

A

D. a portion of TcR and an MHC II moleuclue
- activates T cells without involvement of antigen presenting cell

31
Q

T regulator cells, respomsible for controlling autoimmune antibody produciton express which of the following phenotypes
A. CD3, 4, 8
B. 3, 8, 25
C, 3, 4, 25
D. 8, 25, 56

A

C. CD3, CD4, CD8
- CD25 = IL2 receptor
- CD25 expression is placed in thymus

32
Q

the interaction between individual antigens and antibody molecules depends on several types of bonds. how is the strength of this (single) interaction characterized
A. avidity
B. affinity
C. reactivity
D. valency

A

B. affinity
- avidity = multiple bonds

33
Q

a lab is evaluating an ELISA for detecting antibody to CCP, which is a marker for RA/ the lab includes serum from healthy volunteers and from patients with other connective tissue disease in the eval. these specimens determine which factor of the assay
A. sensitivity
B. precision
C. bia
D. specificity

A

D. specificty

34
Q

the detection of precipitation reactions depends on the presence of optimal proportions of antigen and antibody. a patients sample contains a large amount of antibody, nut the reaction in a test system containing antigen is negative. what has happened
A. performance error
B. low specificity
C. a shift in the zone of equivalence
D. prozone phenomenon

A

D. prozone phenomenon
- excessive antibody takes all antigen sites

35
Q

the positive and negative control values for an ELISA procedure are below their acceptable ranges. what is the most likely cause
A. decay of the positive and negative controls
B. incomplete washing following specimen addition
C. overly long incubation time
D. decay of the antibody enzyme conjugation

A

D. decay of the antibody enzyme conjugation

36
Q

what is the interpretation when an outterlony plate shows crossed lines between wells 1 & 2
A. no reaction between wells
B. partial identity between wells
C. nonidentity between wells
D. identity between wells

A

C. nonidentity between wellsa

37
Q

weight lifter taking many supplements is tested monthly for TSH in a direct capture assay, which uses a streptavidin-biotin indicator system. She has had normal TSH levels for the past 3 months on specimens collected in the late evening. this month she comes in right after breakfast for her blood draw. the TSH level is 3 times her previous level. what may be the cause
A. diurnal variation in TSH levels
B. exogenous biotin in her system from a supplement taken that morning
C. reduced thyroid function caused by an unidentified pathology
D. pipetting error

A

B. exogenous biotin from supplements

38
Q

what compromises the indicator system in an indirect ELISA for detecting antibody
A. enzyme-conjugated antibody + chromogenic substrate
B. enzyme conjugated antigen + chromogenic substrate
C. enzyme + antigen
D. substrate + antigen

A

A. enzyme-conjugated antibody + chromogenic substrate

39
Q

what outcome results from improper washing of a tube or well after adding the enzyme-antibody conjugate in an ELISA system
A. falsely decreased
B. falsely increased
C. unaffected
D. impossible to determine

A

B. falsely increased

40
Q

what would happen if the color reaction phase is prolonged in one tube or well of an ELISA test
A. falsely decreased
B. falsely increased
C. unaffected
D. It is impossible to determine

A

B. falsely incrased
- if the test is not stopped on time the reaction will continue and produce more color

41
Q

the absorbance of a sample measured by ELISA is greater than the highest standard. what corrective action should be taken
A. extrapolate an estimated value from the highest reading
B. repeat the test using a standard of higher concentration
C, repeat the assay using one half the volume of the sample
D. dilute the test sample

A

D. dilute

42
Q

a patient was suspected of having a lymphoproliferative disorder. after several lab tests were completed, the patient was found to have an IgM kappa paraprotein. in what sequence should the lab test leading to this diagnosis be performed
A. serum protein electrophoresis (SPE) followed by immunofixation electrophoresis (IFE)
B. Ig levels, filled by SPE
C. total lymphocyte count, followed by Ig levels
D. Ig levels, followed by urine protein electrophoresis

A

A. SPE followed by IFE
- detect the presence of abnormal ig then IFE to confirm presence and IG type

43
Q

an IFE performed on a serum sample showed a narrow dark band in the lanes containing anti-gamma and anti-lambda how should this result be interpreted
A. abnormally decreased IgG concentration
B. abnormal test result demonstrating monoclonal IgG gamma
C. normal test result
D. impossible to determine without densitometric quantitation

A

B. B. abnormal test result demonstrating monoclonal IgG gamma
- narrow band on both lanes = monoclonal IgG-lambda

44
Q

which type of nephelometry is used to measure immune complex formation almost immediately after the reagent has been added
A. rate
B. endpoint
C. continuous
D, one-dimensional

A

A. rate

45
Q

an antinuclear antibody (ANA) test was performed by using immunofluorescence microscopy assay (IFA) and a clinically significant pattern and titer were reported. positive and negative controls were performed as expected. However, the clinical evaluation of the patient was not consistent with the reported pattern. what is the most likely explanation for this situation
A. the clinical condition of the patient changed since he sample was tested
B. the pattern of fluorescence was misinterpreted
C. the control results were misinterpreted
D. the wrong cell line was used for the test

A

B. pattern was misinterpreted
- pattern must be correlated correctly with specificity of antibodies

46
Q

what corrective action should be taken when a specific pattern cannot be identified in a specimen with a pos ANA IFA
A. repeat the test using a larger volume of sample
B. call the physician
C. have another MLS read the slide
D. dilute the sample and retest

A

D. dilute
- diluting the sample may reveal specificity

47
Q

which statement best describes passive agglutination reactions used for serodiagnosis
A. such agglutination reactions are more rapid because they are single step processes
B. reaction require the addition of a second antibody
C. passive agglutination reactions require biphasic incubation
D. carrier particles for antigen, such as latex particles are used

A

D. carrier particles are used

48
Q

what happened in a titer if tube 5 to 7 show stronger reaction that tube 1 to 4
A. prozone
B. postzone
C. equivalence reaction
D. poor technique

A

A. prozone
- insufficient antigen for antibody concentration

49
Q

what is the titer in tube 8 if tube 1 is undiluted and dilutions are doubled
A. 64
B. 128
C. 256
D. 512

A

B. 128

50
Q

the directions for slide agglutination test instruct that after mixing the patient’s serum and antigen-coated latex particles, the slide must be rotated for 2 minutes. what would happen if the slide were rotated for 10 minutes
A. possible false pos
B. possible false neg
C. no effect
D. depends on amount of antibody present in sample

A

A. false pos

51
Q

what effect does selecting the wrong gate have on the results when cells are counted by flow
A. no effect
B. failure to count the desired cell pop
C. falsely elevated results
D. impossible to determine

A

B. failure to count desired population

52
Q

which statement best describes immunophenotyping
A. lineage determination by detecting antigens on the surface of the gated cells by using fluorescent antibodies
B. ID of cell maturity by using antibodies to detect antigens within the nucleus
C. ID and soting of cells by front and side scatter of light from a laser
D. analysis of cells collected by flow cytometry bu using traditional agglutination reactions

A

A. classificaiton of cells with use of a panel of fluorescent labeled antibodies against specific cell markers

53
Q

a flow cytometry scattergram of a bone marrow sample shows a dense population of cells located in between normal lymphoid and normal myeloid cells. what is te most likely explanation
A. sample was improperly collected
B. abnormal cell pop is present
C. the laser optics are out of alignment
D. the cells are most likely not leukocytes

A

B. abnormal cell pop is presnt

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