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***Medical Lab science review- Robert Harr 4th > immunology-Infectious Diseases > Flashcards

immunology-Infectious Diseases Flashcards

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USMLE® Step 1 flashcards Biology 101 flashcards
1
Q
  1. Which serum antibody response usually
    characterizes the primary (early) stage of syphilis?
    A. Antibodies against syphilis are undetectable
    B. Detected 1–3 weeks after appearance of the
    primary chancre
    C. Detected in 50% of cases before the primary
    chancre disappears
    D. Detected within 2 weeks after infection
A

B.. Detected 1–3 weeks after appearance of the
primary chancre

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2
Q
  1. What substance is detected by the rapid plasma
    reagin (RPR) and Venereal Disease Research
    Laboratory (VDRL) tests for syphilis?
    A. Cardiolipin
    B. Anticardiolipin antibody
    C. Anti-T. pallidum antibody
    D. Treponema pallidum
A

B. Anticardiolipin antibody

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3
Q
  1. What type of antigen is used in the RPR card test?
    A. Live treponemal organisms
    B. Killed suspension of treponemal organisms
    C. Cardiolipin
    D. Tanned sheep cells
A

C. Cardiolipin

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4
Q
  1. Which of the following is the most sensitive test to
    detect congenital syphilis?
    A. VDRL
    B. RPR
    C. Microhemagglutinin test for T. pallidum
    (MHA-TP)
    D. Polymerase chain reaction (PCR)
A

D. Polymerase chain reaction (PCR)

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5
Q
  1. A biological false-positive reaction is least likely
    with which test for syphilis?
    A. VDRL
    B. Fluorescent T. pallidum antibody absorption test
    (FTA-ABS)
    C. RPR
    D. All are equally likely to detect a false-positive
    result
A

B. Fluorescent T. pallidum antibody absorption test
(FTA-ABS)

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6
Q
  1. A 12-year old girl has symptoms of fatigue and a
    localized lymphadenopathy. Laboratory tests reveal
    a peripheral blood lymphocytosis, a positive RPR,
    and a positive spot test for IM. What test should
    be performed next?
    A. HIV test by ELISA
    B. VDRL
    C. Epstein–Barr virus (EBV) specific antigen test
    D. Treponema pallidum particle agglutination
    (TP-PA) test
A

D. Treponema pallidum particle agglutination
(TP-PA) test

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7
Q
  1. Which test is most likely to be positive in the
    tertiary stage of syphilis?
    A. FTA-ABS
    B. RPR
    C. VDRL
    D. Reagin screen test (RST)
A

A. FTA-ABS

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8
Q
  1. What is the most likely interpretation of the
    following syphilis serological results?

RPR: reactive; VDRL: reactive; MHA-TP: nonreactive

A. Neurosyphilis
B. Secondary syphilis
C. Syphilis that has been successfully treated
D. Biological false positive

A

D. Biological false positive

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9
Q
  1. Which specimen is the sample of choice to
    evaluate latent or tertiary syphilis?
    A. Serum sample
    B. Chancre fluid
    C. CSF
    D. Joint fluid
A

C. CSF

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10
Q
  1. Interpret the following quantitative RPR test
    results.
    RPR titer: weakly reactive 1:8; reactive 1:8–1:64
    A. Excess antibody, prozone effect
    B. Excess antigen, postzone effect
    C. Equivalence of antigen and antibody
    D. Impossible to interpret; testing error
A

A. Excess antibody, prozone effect

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11
Q
  1. Tests to identify infection with HIV fall into
    which three general classification types of tests?
    A. Tissue culture, antigen, and antibody tests
    B. Tests for antigens, antibodies, and nucleic acid
    C. DNA probe, DNA amplification, and Western
    blot tests
    D. ELISA, Western blot, and Southern blot tests
A

B. Tests for antigens, antibodies, and nucleic acid

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12
Q
  1. Which tests are considered screening tests
    for HIV?
    A. ELISA, 4th generation, and rapid antibody tests
    B. Immunofluorescence, Western blot,
    radioimmuno-precipitation assay
    C. Culture, antigen capture assay, DNA
    amplification
    D. Reverse transcriptase and messenger RNA
    (mRNA) assay
A

A. ELISA, 4th generation, and rapid antibody tests

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13
Q
  1. Which tests are considered confirmatory tests
    for HIV?
    A. ELISA and rapid antibody tests
    B. Western blot test, HIC-1,2 differentiation assays,
    and polymerase chain reaction
    C. Culture, antigen capture assay, polymerase chain
    reaction
    D. Reverse transcriptase and mRNA assay
A

B. Western blot test, HIC-1,2 differentiation assays,
and polymerase chain reaction

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14
Q
  1. Which is most likely a positive Western blot result
    for infection with HIV?
    A. Band at p24
    B. Band at gp60
    C. Bands at p24 and p31
    D. Bands at p24 and gp120
A

D. Bands at p24 and gp120

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15
Q
  1. A woman who has had five pregnancies
    subsequently tests positive for HIV by Western
    blot. What is the most likely reason for this result?
    A. Possible cross-reaction with herpes or EBV
    antibodies
    B. Interference from medication
    C. Cross-reaction with HLA antigens in the antigen
    preparation
    D. Possible technical error
A

C. Cross-reaction with HLA antigens in the antigen
preparation

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16
Q
  1. Interpret the following results for HIV infection.

ELISA: positive; repeat ELISA: negative; Western blot:
no bands

A. Positive for HIV
B. Negative for HIV
C. Indeterminate
D. Further testing needed

A

B. Negative for HIV

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17
Q
  1. Interpret the following results for HIV infection.
    HIV 1,2 ELISA: positive; HIV-1 Western blot:
    indeterminate; HIV-1 p24 antigen: negative
    A. Positive for antibodies to human
    immunodeficiency virus, HIV-1
    B. Positive for antibodies to human
    immunodeficiency virus, HIV-2
    C. Cross reaction; biological false-positive result
    D. Additional testing required
A

D. Additional testing required

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18
Q
  1. What is the most likely explanation when antibody
    tests for HIV are negative but a polymerase chain
    reaction test performed 1 week later is positive?
    A. Probably not HIV infection
    B. Patient is in the “window phase” before antibody
    production
    C. Tests were performed incorrectly
    D. Clinical signs may be misinterpreted
A

B. Patient is in the “window phase” before antibody
production

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19
Q
  1. What criteria constitute the classification system
    for HIV infection?
    A. CD4-positive T-cell count and clinical
    symptoms
    B. Clinical symptoms, condition, duration, and
    number of positive bands on Western blot
    C. Presence or absence of lymphadenopathy
    D. Positive bands on Western blot and
    CD8-positive T-cell count
A

A. CD4-positive T-cell count and clinical
symptoms

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20
Q
  1. What is the main difficulty associated with the
    development of an HIV vaccine?
    A. The virus has been difficult to culture; antigen
    extraction and concentration are extremely
    laborious
    B. Human trials cannot be performed
    C. Different strains of the virus are genetically
    diverse
    D. Anti-idiotype antibodies cannot be developed
A

C. Different strains of the virus are genetically
diverse

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21
Q
  1. Which CD4:CD8 ratio is most likely in a patient
    with acquired immunodeficiency syndrome (AIDS)?
    A. 2:1
    B. 3:1
    C. 2:3
    D. 1:2
A

D. 1:2

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22
Q
  1. What is the advantage of 4th-generation rapid
    HIV tests over earlier rapid HIV tests?
    A. They use recombinant antigens
    B. They detect multiple strains of HIV
    C. They detect p24 antigen
    D. They are quantitativ
A

C. They detect p24 antigen

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23
Q
  1. Which method is used to test for HIV infection in
    infants who are born to HIV-positive mothers?
    A. ELISA
    B. Western blot test
    C. Polymerase chain reaction
    D. Viral culture
A

C. Polymerase chain reaction

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24
Q
  1. What is the most likely cause when a Western blot
    or ELISA is positive for all controls and samples?
    A. Improper pipetting
    B. Improper washing
    C. Improper addition of sample
    D. Improper reading
A

B. Improper washing

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25
Q
  1. What constitutes a diagnosis of viral hepatitis?
    A. Abnormal test results for liver enzymes
    B. Clinical signs and symptoms
    C. Positive results for hepatitis markers
    D. All of these options
A

D. All of these options

26
Q
  1. Which of the following statements regarding
    infection with hepatitis D virus is true?
    A. Occurs in patients with HIV infection
    B. Does not progress to chronic hepatitis
    C. Occurs in patients with hepatitis B
    D. Is not spread through blood or sexual contact
A

C. Occurs in patients with hepatitis B

27
Q
  1. All of the following hepatitis viruses are spread
    through blood or blood products except:
    A. Hepatitis A
    B. Hepatitis B
    C. Hepatitis C
    D. Hepatitis D
A

A. Hepatitis A

28
Q
  1. Which hepatitis B marker is the best indicator of
    early acute infection?
    A. HBsAg
    B. HBeAg
    C. Anti-HBc
    D. Anti-HBs
A

A. HBsAg

29
Q
  1. Which is the first antibody detected in serum
    after infection with hepatitis B virus (HBV)?
    A. Anti-HBs
    B. Anti-HBc IgM
    C. Anti-HBe
    D. All are detectable at the same time
A

B. Anti-HBc IgM

30
Q
  1. Which antibody persists in low-level carriers of
    hepatitis B virus?
    A. IgM anti-HBc
    B. IgG anti-HBc
    C. IgM anti-HBe
    D. IgG anti-HBs
A

B. IgG anti-HBc

31
Q
  1. What is the most likely explanation when a
    patient has clinical signs of viral hepatitis but tests
    negative for hepatitis A IgM, hepatitis B surface
    antigen, and hepatitis C Ab?
    A. Tests were performed improperly
    B. The patient does not have hepatitis
    C. The patient may be in the “core window”
    D. Clinical evaluation was performed improperly
A

C. The patient may be in the “core window

32
Q
  1. Which hepatitis B markers should be performed
    on blood products?
    A. HBsAg and anti-HBc
    B. Anti-HBs and anti-HBc
    C. HBeAg and HBcAg
    D. Anti-HBs and HBeAg
A

A. HBsAg and anti-HBc

33
Q
  1. Which hepatitis antibody confers immunity
    against reinfection with hepatitis B virus?
    A. Anti-HBc IgM
    B. Anti-HBc IgG
    C. Anti-HBe
    D. Anti-HBs
A

D. Anti-HBs

34
Q
  1. Which test, other than serological markers, is most
    consistently elevated in viral hepatitis?
    A. Antinuclear antibodies
    B. Alanine aminotransferase (ALT)
    C. Absolute lymphocyte count
    D. Lactate dehydrogenase
A

B. Alanine aminotransferase (ALT)

35
Q
  1. If only anti-HBs is positive, which of the following
    can be ruled out?
    A. Hepatitis B virus vaccination
    B. Distant past infection with hepatitis B virus
    C. Hepatitis B immune globulin (HBIG) injection
    D. Chronic hepatitis B virus infection
A

D. Chronic hepatitis B virus infection

36
Q
  1. Interpret the following results for EBV infection:
    IgG and IgM antibodies to viral capsid antigen
    (VCA) are positive.
    A. Infection in the past
    B. Infection with a mutual enhancer virus such
    as HIV
    C. Current infection
    D. Impossible to interpret; need more information
A

C. Current infection

37
Q
  1. Which statement concerning non-Forssman
    heterophile antibody is true?
    A. It is not absorbed by guinea pig antigen
    B. It is absorbed by guinea pig antigen
    C. It does not agglutinate horse RBCs
    D. It does not agglutinate sheep RBCs
A

A. It is not absorbed by guinea pig antigen

38
Q
  1. Given a heterophile antibody titer of 224, which
    of the following results indicate IM ?
A

A.

39
Q
  1. Given a heterophile antibody titer of 224, which of the following results indicate serum sickness ?
A

C.

40
Q
  1. Given a heterophile antibody titer of 224, which
    of the following results indicate an error in testing?
A

B.

41
Q
  1. Blood products are tested for which virus before
    being transfused to newborns?
    A. EBV
    B. Human T-lymphotropic virus II (HTLV-II)
    C. Cytomegalovirus (CMV)
    D. Hepatitis D virus
A

C. Cytomegalovirus (CMV)

42
Q
  1. What is the endpoint for the antistreptolysin O
    (ASO) latex agglutination assay?
    A. Highest serum dilution that shows no
    agglutination
    B. Highest serum dilution that shows agglutination
    C. Lowest serum dilution that shows agglutination
    D. Lowest serum dilution that shows no
    agglutination
A

B. Highest serum dilution that shows agglutination

43
Q
  1. Interpret the following ASO results:

Tube Nos. 1–4 (Todd unit 125): no hemolysis;
Tube No. 5 (Todd unit 166): hemolysis

A. Positive Todd unit 125
B. Positive Todd unit 166
C. No antistreptolysin O present
D. Impossible to interpret

A

A. Positive Todd unit 125

44
Q
  1. Which control shows the correct result for a valid
    ASO test?
    A. SLO control, no hemolysis
    B. Red cell control, no hemolysis
    C. Positive control, hemolysis in all tubes
    D. Hemolysis in both SLO and red cell control
A

B. Red cell control, no hemolysis

45
Q
  1. A streptozyme test was performed, but the result
    was negative, even though the patient showed
    clinical signs of a streptococcal throat infection.
    What should be done next?
    A. Either ASO or anti-deoxyribonuclease B
    (anti-DNase B) testing
    B. Another streptozyme test using diluted serum
    C. Antihyaluronidase testing
    D. Wait for 3–5 days and repeat the streptozyme
    test
A

A. Either ASO or anti-deoxyribonuclease B
(anti-DNase B) testing

46
Q
  1. Rapid assays for influenza that utilize specimens
    obtained from nasopharyngeal swabs detect:
    A. IgM anti-influenza
    B. IgA anti-influenza
    C. IgA-influenza Ag immune complexes
    D. Influenza antigen
A

D. Influenza antigen

47
Q
  1. How can interfering cold agglutinins be removed
    from a test sample?
    A. Centrifuge the serum and remove the top layer
    B. Incubate the clot at 1°C–4°C for several hours,
    then remove serum
    C. Incubate the serum at 56°C in a water bath for
    30 minutes
    D. Use an anticoagulated sample
A

B. Incubate the clot at 1°C–4°C for several hours,
then remove serum

48
Q
  1. All tubes (dilutions) except the negative control are
    positive for cold agglutinins. This indicates:
    A. Contaminated red cells
    B. A rare antibody against red cell antigens
    C. The sample was stored at 4°C prior to separating
    serum and cells
    D. Further serial dilution is necessary
A

D. Further serial dilution is necessary

49
Q
  1. All positive cold agglutinin tubes remain positive
    after 37°C incubation except the positive control.
    What is the most likely explanation for this
    situation?
    A. High titer cold agglutinins
    B. Contamination of the test system
    C. Antibody other than cold agglutinins
    D. Faulty water bath
A

C. Antibody other than cold agglutinins

50
Q
  1. Which increase in antibody titer (dilution) best
    indicates an acute infection?
    A. From 1:2 to 1:8
    B. From 1:4 to 1:16
    C. From 1:16 to 1:256
    D. From 1:64 to 1:128
A

C. From 1:16 to 1:256

51
Q
  1. Which of the following positive antibody tests
    may be an indication of recent vaccination or early
    primary infection for rubella in a patient with no
    clinical symptoms?
    A. Only IgG antibodies positive
    B. Only IgM antibodies positive
    C. Both IgG and IgM antibodies positive
    D. Fourfold rise in titer for IgG antibodies
A

B. Only IgM antibodies positive

52
Q
  1. Why is laboratory diagnosis difficult in cases of
    Lyme disease?
    A. Clinical response may not be apparent upon
    initial infection; IgM antibody may not be
    detected until 3–6 weeks after the infection
    B. Laboratory tests may be designed to detect whole
    Borrelia burgdorferi, not flagellar antigen found
    early in infection
    C. Most laboratory tests are technically demanding
    and lack specificity
    D. Antibodies formed initially to B. burgdorferi may
    cross react in antigen tests for autoimmune diseases
A

A. Clinical response may not be apparent upon
initial infection; IgM antibody may not be
detected until 3–6 weeks after the infection

53
Q
  1. Serological tests for which disease may give a falsepositive result if the patient has Lyme disease?
    A. AIDS
    B. Syphilis
    C. Cold agglutinins
    D. Hepatitis C
A

B. Syphilis

54
Q
  1. In monitoring an HIV-infected patient, which
    parameter may be expected to be the most
    sensitive indicator of the effectiveness of
    antiretroviral treatment?
    A. HIV antibody titer
    B. CD4:CD8 ratio
    C. HIV viral load
    D. Absolute total T-cell count
A

C. HIV viral load

55
Q
  1. A renal transplant recipient is found to have a
    rising creatinine level and reduced urine output.
    The physician orders a “Urine PCR” assay. When
    you call to find out what organism the physician
    wants to identify, you are told:
    A. Hepatitis C virus
    B. Legionella pneumophila
    C. EBV
    D. BK virus
A

D. BK virus

56
Q
  1. A newborn is to be tested for a vertically
    transmitted HIV infection. Which of the
    following tests is most useful?
    A. HIV PCR
    B. CD4 count
    C. Rapid HIV antibody test
    D. HIV IgM antibody test
A

A. HIV PCR

57
Q
  1. Which of the following methods used for HIV
    identification is considered a signal amplification
    technique?
    A. Branched chain DNA analysis
    B. DNA PCR
    C. Reverse transcriptase PCR
    D. Nucleic acid sequence based assay (NASBA)
A

A. Branched chain DNA analysis

58
Q
  1. Which of the following fungal organisms is best
    diagnosed by an antibody detection test as opposed
    to an antibody detection assay?
    A. Histoplasma
    B. Cryptococcus
    C. Candida
    D. Aspergillus
A

B. Cryptococcus

59
Q
  1. Your cytology laboratory refers a Papanicolaou
    smear specimen to you for an assay designed to
    detect the presence of a virus associated with
    cervical cancer. You perform:
    A. An ELISA assay for anti-HSV-2 antibodies
    B. A molecular assay for HSV-2
    C. An ELISA assay for HPV antibodies
    D. A molecular assay for HPV
A

D. A molecular assay for HPV

60
Q
  1. An immunosuppressed patient has an unexplained
    anemia. The physician suspects a parvovirus
    B19 infection. A parvovirus IgM test is negative.
    The next course of action is to tell the physician:
    A. The patient does not have parvovirus
    B. A convalescent specimen is recommended in
    4 weeks to determine if a fourfold rise in titer
    has occurred
    C. A parvovirus PCR is recommended
    D. That a recent transfusion for the patient’s anemia
    may have resulted in a false-negative assay and
    the patient should be retested in 4 weeks
A

C. A parvovirus PCR is recommended

***Medical Lab science review- Robert Harr 4th (63 decks)

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