Harr’s Medical Laboratory Science Review PART 2 (CHAPTER REVIEW) Flashcards
- What is a general definition for autoimmunity?
A. Increase of tolerance to self-antigens
B. Loss of tolerance to self-antigens
C. Increase in clonal deletion of mutant cells
D. Manifestation of immunosuppression
B. Loss of tolerance to self-antigens
- An ANA test is performed on a specimen from a 55-year-old woman
who has unexplained joint pain. The IFA result shows a titer of 40 and a homogeneous pattern. The appropriate follow-up for this patient is:
A. Anti-DNA assay
B. Extractable nuclear antigen (ENA) testing
C. Retest ANA in 3 to 6 months
D. CH50 complement assay
C. Retest ANA in 3 to 6 months
- Which disease is likely to show a rim (peripheral) pattern in an immunofluorescence (IF) microscopy test for ANA?
A. Mixed connective tissue disease (MCTD)
B. RA
C. SLE
D. Scleroderma
C. SLE
- What type of antibodies is represented by the homogeneous pattern in the IFA for ANAs?
A. Antihistone antibodies
B. Anticentromere antibodies
C. Anti-ENA (anti-Smith [anti-Sm] and anti-ribonucleoprotein
[anti-RNP]) antibodies
D. Anti-RNA antibodies
A. Antihistone antibodies
- A patient’s specimen is strongly positive in an ANA ELISA. Which of the following would not be an appropriate follow-up to this result?
A. IFA on human epithelial type 2 (HEp-2) cells
B. Specific ENA ELISA tests
C. Specific anti-DNA ELISA
D. Rheumatoid factor (RF) assay
D. Rheumatoid factor (RF) assay
- What disease is indicated by a high titer of anti-Sm antibody?
A MCTD
B. RA
C. SLE
D. Scleroderma
C. SLE
- Which disease is least likely when a nucleolar pattern occurs in an IFA for ANAs?
A. MCTD
B. Sjögren syndrome
C. SLE
D. Scleroderma
A. MCTD
- What antibodies are represented by the nucleolar pattern in the IFA for ANAs?
A. Antihistone antibodies
B. Anti-dsDNA antibodies
C. Anti-ENA (anti-Sm and anti-RNP) antibodies
D. Anti-RNA antibodies
A. Antihistone antibodies
- Which test would best distinguish between SLE and MCTD?
A. Multiplex or ELISA test for anti-Sm and anti-RNP
B. IFA using Crithidia as substrate
C. Slide agglutination testing
D. Laboratory tests cannot distinguish between these
disorders
A. Multiplex or ELISA test for anti-Sm and anti-RNP
- An ANA test on HEp-2 cells shows nucleolar staining in interphase cells and dense chromatin staining in mitotic cells. The most likely cause of this staining pattern is:
A. Antifibrillarin antibody
B. Anti–ribosomal P antibody
C. A serum with nucleolar and homogeneous patterns
D. Technical artifact
A. Antifibrillarin antibody
- Which immunofluorescence pattern indicates the need for ENA testing by multiplex, line blots, or ELISA assays?
A. Homogeneous or solid
B. Peripheral or rim
C. Speckled
D. Nucleolar
C. Speckled
- Which of the following is used in rapid slide tests for detection of RFs?
A. Whole IgM molecules
B. Fc portion of the IgG molecule
C. Fab portion of the IgG molecule
D. Fc portion of the IgM molecule
B. Fc portion of the IgG molecule
- Which of the following methods is least likely to give a definitive result for the diagnosis of RA?
A. Nephelometric measurement of anti-IgG
B. Agglutination testing for RF
C. Anti-CCP
D. IFA for ANAs
D. IFA for ANAs
- Which disease might be indicated by antibodies to smooth muscle?
A. Atrophic gastritis
B. Autoimmune hepatitis
C. Myasthenia gravis
D. Sjögren syndrome
B. Autoimmune hepatitis
- Antibodies to thyroid peroxidase may appear in which of the following diseases?
A. Graves disease and Hashimoto thyroiditis
B. Myasthenia gravis
C. Granulomatous thyroid disease
D. Addison disease
A. Graves disease and Hashimoto thyroiditis
- What is the main use of laboratory tests to detect antibodies to islet
cells and insulin in cases of insulin-dependent diabetes mellitus
(IDDM)?
A. To regulate levels of injected insulin
B. To diagnose IDDM
C. To rule out the presence of other autoimmune diseases
D. To screen susceptible individuals prior to destruction of β-cells
D. To screen susceptible individuals prior to destruction of β-cells
- A patient presents with clinical symptoms of celiac disease. Tests for anti-tissue transglutaminase and antigliadin antibodies are negative.
Which of the following tests should be ordered?
A. IgG level
B. HLA DQ2 and DQ8 typing
C. HLA DR3 and DR7 typing
D. IgM level
B. HLA DQ2 and DQ8 typing
- A specimen appears to have a perinuclear staining pattern in an
antineutrophil cytoplasmic antibody (ANCA) immunofluorescent assay
using ethanol-fixed neutrophils, suggesting the possibility of a perinuclear ANCA (pANCA). On which of the following substrates would this specimen display cytoplasmic speckling?
A. Formalin-fixed neutrophils
B. Unfixed neutrophils
C. HEp-2 cells
D. Rabbit kidney tissue
A. Formalin-fixed neutrophils
- Which of the following is a description of a type I hypersensitivity
reaction?
A. Ragweed antigen cross-links with IgE on the surface of mast cells, causing release of preformed mediators and
resulting in symptoms of an allergic reaction
B. Anti-Fya from a pregnant woman crosses the placenta and attaches to the Fya antigenpositive RBCs of the fetus,
destroying the RBCs
C. Immune complex deposition occurs on the glomerular basement membrane of the kidney, leading to renal failure
D. Exposure to poison ivy causes sensitized T cells to release lymphokines that cause a localized inflammatory
reaction
A. Ragweed antigen cross-links with IgE on the surface of mast cells, causing release of preformed mediators and
resulting in symptoms of an allergic reaction
- Why is skin testing the most widely used method to test for a type I
hypersensitivity reaction?
A. It causes less trauma and is more cost effective than other methods
B. It has greater sensitivity than in vitro measurements
C. It is more likely to be positive for IgE-specific allergens compared with other methods
D. It may be used to predict the development of further allergen sensitivity
B. It has greater sensitivity than in vitro measurements
- Which in vitro test measures IgE levels against a specific allergen?
A. Histamine release assay
B. Radioimmunosorbent test (RIST)
C. Fluorescent allergosorbent test (FAST)
D. Precipitin radioimmunosorbent test (PRIST)
C. Fluorescent allergosorbent test (FAST)
- A patient who is blood group O is accidentally transfused with group A blood and develops a reaction during the transfusion. What antibody is involved in this type II reaction?
A. IgM
B. IgE
C. IgG and IgE
D. IgG
A. IgM
- Which test would measure the coating of RBCs by antibody as occurs in hemolytic transfusion reactions?
A. Indirect antiglobulin test (IAT)
B. Direct antiglobulin test (DAT)
C. ELISA
D. Hemagglutination
B. Direct antiglobulin test (DAT)
- Which of the following conditions will most likely result in a false-negative DAT test?
A. Insufficient washing of RBCs
B. Use of heavy chain–specific polyclonal anti-human Ig
C. Use of excessive centrifugal force
D. Use of a sample obtained by finger puncture
A. Insufficient washing of RBCs
- Which test detects antibodies that have attached to tissues, resulting in a type-II cytotoxic reaction?
A. Indirect immunofluorescence
B. Direct immunofluorescence (DIF)
C. Immunofixation electrophoresis (IFE)
D. Hemagglutination
B. Direct immunofluorescence (DIF)
- Which of the following tests will detect circulating immune complexes in the serum of some patients with systemic autoimmune diseases, such as RA?
A. Direct IFA
B. Enzyme immunoassay (EIA)
C. Assay of cryoglobulins
D. IAT
C. Assay of cryoglobulins
- A patient deficient in the C3 complement component would be
expected to mount a normal:
A. Type I and IV hypersensitivity response
B. Type II and IV hypersensitivity response
C. Type I and III hypersensitivity response
D. Type II and III hypersensitivity response
A. Type I and IV hypersensitivity response
- Which of the following symptoms in a young child may indicate an immunodeficiency syndrome?
A. Anaphylactic reactions
B. Severe rashes and myalgia
C. Recurrent bacterial, fungal, and viral infections
D. Weight loss, rapid heartbeat, breathlessness
C. Recurrent bacterial, fungal, and viral infections
- What immune elements are involved in a positive skin test for tuberculosis?
A. IgE antibodies
B. T cells and macrophages
C. NK cells and IgG antibody
D. B cells and IgM antibody
B. T cells and macrophages
- A patient receives a transfusion of packed RBCs and fresh frozen plasma (FFP) and develops an anaphylactic, nonhemolytic reaction. She reports receiving a transfusion 20 years earlier. She had no reaction to the previous transfusion, but she did feel “poorly” a few weeks later. Which of the following transfused substances most likely
elicited the reaction?
A. IgA
B. Group A antigen
C. Rho (D) antigen
D. An antigen belonging to the Duffy system
A. IgA
- What screening test should be performed first in a young patient
suspected of having an immune dysfunction disorder?
A. Complete blood count (CBC) and WBC differential
B. Chemotaxis assay
C. Complement levels
D. Bone marrow biopsy
A. Complete blood count (CBC) and WBC differential