Immunlogy-Immunologic Procedures Flashcards

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1
Q
  1. The interaction between an individual antigen
    and antibody molecule depends upon several
    types of bonds such as ionic bonds, hydrogen
    bonds, hydrophobic bonds, and van der Waals
    forces. How is the strength of this attraction
    characterized?
    A. Avidity
    B. Affinity
    C. Reactivity
    D. Valency
A

B. Affinity

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2
Q
  1. A laboratory is evaluating an enzyme-linked
    immunosorbent assay (ELISA) for detecting an
    antibody to cyclic citrullinated peptide (CCP),
    which is a marker for rheumatoid arthritis. The
    laboratory includes serum from healthy volunteers
    and patients with other connective tissue diseases
    in the evaluation. These specimens determine
    which factor of the assay?
    A. Sensitivity
    B. Precision
    C. Bias
    D. Specificity
A

D. Specificity

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3
Q
  1. The detection of precipitation reactions depends
    on the presence of optimal proportions of antigen
    and antibody. A patient’s sample contains a large
    amount of antibody, but 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

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4
Q
  1. Which part of the radial immunodiffusion (RID)
    test system contains the antisera?
    A. Center well
    B. Outer wells
    C. Gel
    D. Antisera may be added to any well
A

C. Gel

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5
Q
  1. What is the interpretation when an Ouchterlony
    plate shows crossed lines between wells 1 and 2
    (antigen is placed in the center well and antisera in
    wells 1 and 2)?
    A. No reaction between wells 1 and 2
    B. Partial identity between wells 1 and 2
    C. Nonidentity between wells 1 and 2
    D. Identity between wells 1 and 2
A

C. Nonidentity between wells 1 and 2

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6
Q
  1. Why is a chemiluminescent immunoassay (CIA) or
    enzyme immunoassay (EIA) the method of choice
    for detection of certain analytes, such as hormones,
    normally found in low concentrations?
    A. Because of low cross reactivity
    B. Because of high specificity
    C. Because of high sensitivity
    D. Because test systems may be designed as both
    competitive and noncompetitive assays
A

C. Because of high sensitivity

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7
Q
  1. What comprises 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

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8
Q
  1. What outcome results from improper washing of a
    tube or well after adding the enzyme–antibody
    conjugate in an ELISA system?
    A. Result will be falsely decreased
    B. Result will be falsely increased
    C. Result will be unaffected
    D. Result is impossible to determine
A

B. Result will be falsely increased

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9
Q
  1. What would happen if the color reaction phase is
    prolonged in one tube or well of an ELISA test?
    A. Result will be falsely decreased
    B. Result will be falsely increased
    C. Result will be unaffected
    D. Impossible to determine
A

B. Result will be falsely increased

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10
Q
  1. 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 the test sample

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11
Q
  1. A patient was suspected of having a
    lymphoproliferative disorder. After several
    laboratory tests were completed, the patient was
    found to have an IgMκ paraprotein. In what
    sequence should the laboratory tests leading to
    this diagnosis have been performed?
    A. Serum protein electrophoresis (SPE) followed
    by immunofixation electrophoresis (IFE)
    B. Immunoglobulin levels followed by SPE
    C. Total lymphocyte count followed by
    immunoglobulin levels
    D. Immunoglobulin levels followed by urine protein
    electrophoresis
A

A. Serum protein electrophoresis (SPE) followed
by immunofixation electrophoresis (IFE)

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12
Q
  1. An IFE performed on a serum sample showed a
    narrow dark band in the lanes containing anti-γ
    and anti-λ. How should this result be interpreted?
    A. Abnormally decreased IgG concentration
    B. Abnormal test result demonstrating monoclonal
    IgGλ
    C. Normal test result
    D. Impossible to determine without densitometric
    quantitation
A

B. Abnormal test result demonstrating monoclonal
IgGλ

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13
Q
  1. Which type of nephelometry is used to measure
    immune complex formation almost immediately
    after reagent has been added?
    A. Rate
    B. Endpoint
    C. Continuous
    D. One dimensional
A

A. Rate

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14
Q
  1. An immunofluorescence microscopy assay (IFA)
    was performed, and a significant antibody titer was
    reported. Positive and negative controls performed
    as expected. However, the clinical evaluation of the
    patient was not consistent with a positive finding.
    What is the most likely explanation of this
    situation?
    A. The clinical condition of the patient changed
    since the 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. The pattern of fluorescence was misinterpreted

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15
Q
  1. What corrective action should be taken when an
    indeterminate pattern occurs in an indirect IFA?
    A. Repeat the test using a larger volume of sample
    B. Call the physician
    C. Have another medical laboratory scientist read
    the slide
    D. Dilute the sample and retest
A

D. Dilute the sample and retest

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16
Q
  1. Which statement best describes passive
    agglutination reactions used for serodiagnosis?
    A. Such agglutination reactions are more rapid
    because they are a single-step process
    B. Reactions 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 for antigen such as latex particles
are used

17
Q
  1. What has happened in a titer, if tube Nos. 5–7
    show a stronger reaction than tube Nos.1–4?
    A. Prozone reaction
    B. Postzone reaction
    C. Equivalence reaction
    D. Poor technique
A

A. Prozone reaction

18
Q
  1. What is the titer in tube No. 8 if tube No. 1 is
    undiluted and dilutions are doubled?
    A. 64
    B. 128
    C. 256
    D. 512
A

B. 128

19
Q
  1. The directions for a slide agglutination test
    instruct that after mixing the patient’s serum
    and latex particles, the slide must be rotated for
    2 minutes. What would happen if the slide were
    rotated for 10 minutes?
    A. Possible false-positive result
    B. Possible false-negative result
    C. No effect
    D. Depends on the amount of antibody present in
    the sample
A

A. Possible false-positive result

20
Q
  1. Which outcome indicates a negative result in a
    complement fixation test?
    A. Hemagglutination
    B. Absence of hemagglutination
    C. Hemolysis
    D. Absence of hemolysis
A

C. Hemolysis

21
Q
  1. What effect does selecting the wrong gate have
    on the results when cells are counted by flow
    cytometry?
    A. No effect
    B. Failure to count the desired cell population
    C. Falsely elevated results
    D. Impossible to determine
A

B. Failure to count the desired cell population

22
Q
  1. Which statement best describes
    immunophenotyping?
    A. Lineage determination by detecting antigens on
    the surface of the gated cells using fluorescent
    antibodies
    B. Identification of cell maturity using antibodies to
    detect antigens within the nucleus
    C. Identification and sorting of cells by front and
    side-scatter of light from a laser
    D. Analysis of cells collected by flow cytometry
    using traditional agglutination reactions
A

A. Lineage determination by detecting antigens on
the surface of the gated cells using fluorescent
antibodies

23
Q
  1. 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 the most likely explanation?
    A. The sample was improperly collected
    B. An abnormal cell population is present
    C. The laser optics are out of alignment
    D. The cells are most likely not leukocytes
A

B. An abnormal cell population is present