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1
Q

Killer immunoglobulin-like receptor (KIR) system. KIRs are one of several types of cell surface molecules that regulate the activity of NK lymphocytes. Alloreactive NK cells have been shown to mediate a graft-versus-leukemia (GVL) reaction and prevent relapse after transplantation for certain types of hematologic malignancies.

A

Noted, these alloreactive NK cells have been shown to mediate a graft-versus-leukemia (GVL) reaction and prevent relapse after transplantation for certain types of hematologic malignancies.

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2
Q

Serologic HLA testing uses a form of complement- dependent microlymphocytotoxicity (CDC) performed in 60-well or 72-well microtiter trays. Trays are usually read on:

Brightfield microscopes
Darkfield microscopes
Polarizing microscopes
Inverted phase contrast microscopes

A

Inverted phase contrast microscopes

Trays are usually read on inverted phase contrast microscopes. In the properly adjusted phase, cells that have not been injured appear small, bright, and refractile. Injured cells that have taken up eosin-Y or trypan blue owing to antibody and complement-mediated damage will flatten and appear large, dark, and nonrefractile.

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3
Q

In the production of hybridoma, plasma cells are harvested from:

Rabbit kidney
Rabbit spleen
Mouse liver
Mouse spleen

A

Mouse spleen

The production of hybridomas begins by immunizing a mouse with a certain antigen. After a time, the mouse’s spleen cells are harvested. Spleen cells are combined with myeloma cells in the presence of polyethylene glycol (PEG), a surfactant. The PEG brings about fusion of plasma cells with myeloma cells, producing a hybridoma.

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4
Q

In fluorescent antinuclear antibody testing, _______ or human epithelial HEp-2 cells are fixed to a slide and allowed to react with patient serum.

Rabbit kidney
Rabbit spleen
Mouse kidney
Mouse spleen

A

Mouse kidney

In fluorescent antinuclear antibody (FANA) testing, mouse kidney or human epithelial HEp-2 cells are fixed to a slide and allowed to react with patient serum.

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5
Q

Which receptor on T cells is responsible for rosetting with sheep red blood cells?

CD2
CD3
CD4
CD8

A

CD2

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6
Q

Carrier particles to which antigens are attached in Streptozyme testing:

Bentonite
Charcoal
Horse RBCs
Sheep RBCs

A

Bentonite

The Streptozyme test is a slide agglutination screening test for the detection of antibodies to several streptococcal antigens. Sheep red blood cells are coated with streptolysin, streptokinase, hyaluronidase, DNase, and NADase so that antibodies to any of the streptococcal antigens can be detected.

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7
Q

Marginal B cells remain in the:

Bone marrow
Lymph nodes
Spleen
Peyer’s patches

A

Spleen

In the spleen, immature B cells develop into mature cells known as marginal zone B cells. These B cells remain in the spleen in order to respond quickly to any blood-borne pathogens they may come into contact with.

Other immature B cells become follicular B cells, which are found in lymph nodes and other secondary organs.

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8
Q

Primary antibody found in Helicobacter pylori infection:

IgA
IgD
IgG
IgM

A

IgG

Most serological tests in clinical use detect H. pylori–specific antibodies of the IgG class. Although IgM antibody is produced in H. pylori infections, testing for its presence lacks clinical value, since most infections have become chronic before diagnosis. Thus, IgG is the primary antibody found.

IgA testing has a lower sensitivity and specificity than IgG testing, but it may increase sensitivity of detection when used in conjunction with IgG testing.

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9
Q

Mantoux tuberculin test:

Type I hypersensitivity reaction
Type II hypersensitivity reaction
Type III hypersensitivity reaction
Type IV hypersensitivity reaction

A

Type IV hypersensitivity reaction

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10
Q

The process by which cells are capable of moving from the circulating blood to the tissues by squeezing through the wall of a blood vessel:

Chemotaxis
Diapedesis
Endosmosis
Phagocytosis

A

Diapedesis

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11
Q

The migration of cells in the direction of a chemical messenger:

Chemotaxis
Diapedesis
Endosmosis
Phagocytosis

A

Chemotaxis

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12
Q

In plasma, it is associated with HDL cholesterol, and it is thought to play a role in metabolism of cholesterol:

Alpha1-antitrypsin
Fibrinogen
Mannose-binding lectin
Serum amyloid A

A

Serum amyloid A

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13
Q

Serum amyloid A has been found to increase significantly more in

Bacterial infections
Fungal infections
Parasitic infections
Viral infections

A

Bacterial infections

SERUM AMYLOID A
It has been found to increase significantly more in bacterial infections than in viral infections.

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14
Q

Cells that express CD56 and/or CD16:

B cells
T cells
NK cells
All of the above

A

NK cells

Two subsets of NK cells exist—those that have a high level of CD56 and low or no CD16, and those with some CD56 and high levels of CD16.

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15
Q

For serum VDRL, the slide is rotated at:

100 rpm for 4 minutes
100 rpm for 8 minutes
180 rpm for 4 minutes
180 rpm for 6 minutes

A

180 rpm for 4 minutes

SERUM VDRL
The slide is rotated for 4 minutes on a rotator at 180 rpm. It is read microscopically to determine the presence of flocculation, or small clumps. The results are recorded as reactive (medium to large clumps), weakly reactive (small clumps), or nonreactive (no clumps or slight roughness).

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16
Q

For RPR, the card is rotated at:

100 rpm for 4 minutes
100 rpm for 8 minutes
180 rpm for 4 minutes
180 rpm for 8 minutes

A

100 rpm for 8 minutes

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17
Q

Most heat-labile of all immunoglobulins:

IgA
IgD
IgE
IgM

A

IgE

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18
Q

IgE has the ability to activate:

B cells
B cells and T cells
Basophils and mast cells
Eosinophils and neutrophils

A

Basophils and mast cells

IgE is best known for its very low concentration in serum and the fact that it has the ability to activate mast cells and basophils.

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19
Q

IgE recruits _____________ to the area to help destroy invading antigens that have penetrated IgA defenses:

B cells
B cells and T cells
Basophils and mast cells
Eosinophils and neutrophils

A

Eosinophils and neutrophils

IgE appears to be a nuisance antibody; however, it may serve a protective role by triggering an acute inflammatory reaction that recruits neutrophils and eosinophils to the area to help destroy invading antigens that have penetrated IgA defenses.

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20
Q

The classical complement pathway is activated by:

Most viruses
Antigen–antibody complexes
Fungal cell walls
All of the above

A

Antigen–antibody complexes

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21
Q

Triggering substances for the alternative pathway:

Antigen-antibody complex
Bacterial cell walls, especially those containing lipopolysaccharide; fungal cell walls; yeast; viruses; virally infected cells; tumor cell lines; and some parasites, especially trypanosomes
Microorganisms with mannose or similar sugars in their cell wall
All of the above

A

Bacterial cell walls, especially those containing lipopolysaccharide; fungal cell walls; yeast; viruses; virally infected cells; tumor cell lines; and some parasites, especially trypanosomes

Triggering substances for the alternative pathway include bacterial cell walls, especially those containing lipopolysaccharide; fungal cell walls; yeast; viruses; virally infected cells; tumor cell lines; and some parasites, especially trypanosomes. All of these can serve as sites for binding the complex C3bBb, one of the end products of this pathway.

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22
Q

Mannose-binding protein in the lectin pathway is most similar to which classical pathway component?

C3b
C1rs
C1q
C4

A

C1q

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23
Q

An antigen that triggers a type I hypersensitivity response:

Hapten
Histamine
Allergen
Oncogene

A

Allergen

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24
Q

Cytokines produced by T cells and other cell lines that inhibit viral synthesis or act as immune regulators:

Integrins
Interferons
Complement
Antibodies

A

Interferons

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25
Q

Decreased maternal alpha fetoprotein levels are associated with:

Anencephaly
Down syndrome
Twins or multiple pregnancies
Spina bifida

A

Down syndrome

Causes of increased maternal serum alpha fetoprotein levels?
1. Open neural tube defects such as spina bifida and anencephaly can typically increase MSAFP by double or more.
2. Twins or multiple pregnancies can also increase the result.

Cause of decreased maternal serum alpha fetoprotein levels:
Down syndrome (trisomy 21) and Edwards syndrome (trisomy 18) can cause as much as a 25% decrease in MSAFP.

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26
Q

Positive rheumatoid factor is generally associated with:

Anemia
Azotemia
Decreased ESR
Hyperglobulinemia

A

Hyperglobulinemia

Hypergammaglobulinemia such as polyclonal increase is associated with autoimmune disorders. Hypergammaglobulinemia such as monoclonal increase is associated with such disease states as multiple myeloma, lymphomas, etc.

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27
Q

Skin pH keeps most microorganisms from growing:

5.6
6.5
7.2
8.0

A

5.6

Skin at a pH of approximately 5.6
This acidic pH keeps most microorganisms from growing.

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28
Q

Antigen in the RPR test:

Anti-cardiolipin
Cardiolipin
Charcoal
Reagin

A

Cardiolipin

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29
Q

Microscope used for the Quantitative Buffy Coat (QBC) method for diagnosis of malaria:

Darkfield microscope
Fluorescent microscope
Phase contrast microscope
Polarizing microscope

A

Fluorescent microscope

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30
Q

Color of the AHG reagent:

Red
Yellow
Blue
Green

A

Green

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31
Q

Anticoagulant for the direct AHG test (DAT):

ACD
EDTA
Heparin
Oxalate

A

EDTA

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32
Q

Present in 70% of patients with lupus and are highly specific for the disease:

Anti-DNP
Anti-RNP
Anti-dsDNA
Anti-CCP

A

Anti-dsDNA

Antibodies to dsDNA are present in 70% of patients with lupus and are highly specific for the disease.

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33
Q

T in TORCH or STORCH stands for:

Trichinellosis
Trichuriasis
Toxoplasmosis
None of the above

A

Toxoplasmosis

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34
Q

In the chain of infection, a contaminated work area would serve as which of the following:

Source
Method of transmission
Host
All of the above

A

Source

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35
Q

In the process of phagocytosis, formation of hypochlorite and hydroxyl ions damage _______ irreversibly.

DNA
RNA
Carbohydrates
Proteins

A

Proteins

Formation of hypochlorite and hydroxyl ions damage PROTEINS irreversibly.

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36
Q

Which tumor marker is used to monitor patients with breast cancer for recurrence of disease?

CA 15-3
Estrogen receptor (ER)
Cathepsin-D
CA 50

A

CA 15-3

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37
Q

Antinuclear antibodies (ANA) include:

Abs to DNA
Abs to DNA, abs to nucleolar antigens
Abs to DNA, abs to nucleolar antigens and abs to histone
Abs to DNA, abs to nucleolar antigens, abs to histone and abs to nonhistone proteins

A

Abs to DNA, abs to nucleolar antigens, abs to histone and abs to nonhistone proteins

ANAs can be divided into four groups to provide a systematic classification: antibodies to DNA, antibodies to histone, antibodies to nonhistone proteins, and antibodies to nucleolar antigens.

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38
Q

All are components of the second line of defense, except:

Macrophages
Mast cells
Neutrophils
B cells

A

B cells

SECOND LINE OF DEFENSE:
Cellular
1. Mast cells
2. Neutrophils
3. Macrophages

Humoral
1. Complement
2. Lysozyme
3. Interferon

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39
Q

A vacuole formed within a phagocytic cell as pseudopodia surround a particle during the process of phagocytosis:

Neutrophil
Monocyte
Phagosome
Phagolysosome

A

Phagosome

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40
Q

The structure formed by the fusion of cytoplasmic granules and the phagocytic vacuole during the process of phagocytosis:

Neutrophil
Monocyte
Phagosome
Phagolysosome

A

Phagolysosome

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41
Q

It has been used to treat hepatitis C and Kaposi’s sarcoma, as well as certain leukemias and lymphomas:

TGF-alpha
TGF-beta
IFN-alpha
IFN-beta

A

IFN-alpha

IFN-α has been used to treat hepatitis C and Kaposi’s sarcoma, as well as certain leukemias and lymphomas.

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42
Q

Efficacious in treating multiple sclerosis, although the exact mechanism of action remains unclear:

TGF-alpha
TGF-beta
IFN-alpha
IFN-beta

A

IFN-beta

IFN-β is efficacious in treating multiple sclerosis, although the exact mechanism of action remains unclear.

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43
Q

A single ASO titer is considered to be moderately elevated if the titer is at least ______ Todd units in an adult:

160
200
240
320

A

240

A single ASO titer is considered to be moderately elevated if the titer is at least 240 Todd units in an adult and 320 Todd units in a child.

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44
Q

A single ASO titer is considered to be moderately elevated if the titer is at least ______ Todd units in a child.

160
200
240
320

A

320

A single ASO titer is considered to be moderately elevated if the titer is at least 240 Todd units in an adult and 320 Todd units in a child.

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45
Q

Current recommendations include the combined detection of mannan and anti-mannan antibodies for the specific identification of ______ species in serum samples.

Bordetella
Mycobacterium
Candida
Cryptococcus

A

Candida

Current recommendations include the combined detection of mannan and anti-mannan antibodies for the specific identification of Candida species in serum samples.

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46
Q

Antibodies to which of the following viral antigens are usually the first to be detected in HIV infection?

gp120
gp160
gp41
p24

A

p24

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47
Q

Most sensitive and reliable; reference method for VZV antibody:

Latex agglutination
ELISA
FAMA
PCR

A

FAMA

The most sensitive and reliable method of detecting VZV antibody is a fluorescent test called FAMA (fluorescent antibody to membrane antigen) that detects antibody to the envelope glycoproteins of the virus.

While FAMA is considered to be the reference method for VZV antibody, it requires live, virus-infected cells and is not suitable for large-scale routine testing.

48
Q

The most commonly used method to detect VZV antibodies in the clinical laboratory:

Latex agglutination
ELISA
FAMA
PCR

A

ELISA

The most commonly used method to detect VZV antibodies in the clinical laboratory is the ELISA because it is automated, provides objective results, and does not require viral culture.

49
Q

Most common cause of congenital infections:

Cytomegalovirus
Rubella
Syphilis
Toxoplasmosis

A

Cytomegalovirus

CMV is also the most common cause of congenital infections, occurring in approximately 1 percent of all neonates.

50
Q

Method of choice for diagnosis of congenital toxoplasmosis:

EIA
IFA
FAMA
PCR

A

EIA

Enzyme immunoassays (EIA) for IgM, IgG, or IgA and indirect fluorescent antibody (IFA) assays for IgG are available and should be performed when congenital toxoplasmosis is suspected.

IFA testing has been widely used, but EIA is the method of choice, as it is more sensitive, less difficult to perform, and easier to interpret.

51
Q

Prenatal congenital toxoplasmosis can be diagnosed by performing ______ on amniotic fluid to detect T. gondii DNA.

EIA
IFA
FAMA
PCR

A

PCR

Prenatal congenital toxoplasmosis can be diagnosed by performing polymerase chain reaction (PCR) technology on amniotic fluid to detect T. gondii DNA.

52
Q

Method of choice to detect T. gondii DNA in CSF:

EIA
IFA
FAMA
PCR

A

PCR

Currently, there are no useful serological procedures for diagnosing CNS infection in immunocompromised patients. These individuals often do not produce detectable levels of specific antibody against the parasite, and procedures to detect circulating antigen appear to lack sensitivity. PCR is, therefore, the method of choice to detect T. gondii DNA in CSF.

53
Q

The cells that Metchnikoff first observed are associated with which phenomenon?

Innate immunity
Adaptive immunity
Humoral immunity
Specific immunity

A

Innate immunity

54
Q

Which of the following statements is true of NK cells?

They rely upon memory for antigen recognition.
They have the same CD groups as B cells.
They are found mainly in lymph nodes.
They kill target cells without prior exposure to them.

A

They kill target cells without prior exposure to them.

55
Q

Which cell is the most potent phagocytic cell in the tissue?

Neutrophil
Dendritic cell
Eosinophil
Basophil

A

Dendritic cell

56
Q

A cell characterized by a nucleus with two to five lobes, a diameter of 10 to 15 μm, and a large number of neutral staining granules is identified as a(n):

Eosinophil
Monocyte
Basophil
Neutrophil

A

Neutrophil

57
Q

Where do lymphocytes mainly come in contact with antigens?

Secondary lymphoid organs
Bloodstream
Bone marrow
Thymus

A

Secondary lymphoid organs

58
Q

Which of the following statements best characterizes adaptive immunity?

Relies on normally present body functions
Response is similar for each exposure
Specificity for each individual pathogen
Involves only cellular immunity

A

Specificity for each individual pathogen

59
Q

The main function of T cells in the immune response is to:

Produce cytokines that regulate both innate and adaptive immunity
Produce antibodies
Participate actively in phagocytosis
Respond to target cells without prior exposure

A

Produce cytokines that regulate both innate and adaptive immunity

60
Q

Antigenic groups identified by different sets of antibodies reacting in a similar manner to certain standard cell lines best describes:

Cytokines
Clusters of differentiation (CD)
Neutrophilic granules
Opsonins

A

Clusters of differentiation (CD)

61
Q

All of the following are characteristics of an effective immunogen except:

Internal complexity
Large molecular weight
Presence of numerous epitopes
Found on host cells

A

Found on host cells

62
Q

HLA molecules A, B, and C belong to which MHC class?

Class I
Class II
Class III
Class IV

A

Class I

63
Q

Which best explains the difference between immunogens and antigens?

Only antigens are large enough to be recognized by T cells
Only immunogens can react with antibody
Only immunogens can trigger an immune response
Only antigens are recognized as foreign.

A

Only immunogens can trigger an immune response

64
Q

The term for enhancement of phagocytosis by coating of foreign particles with serum proteins is

Opsonization
Agglutination
Solubilization
Chemotaxis

A

Opsonization

65
Q

How do cytotoxic T cells kill target cells?

They produce antibodies that bind to the cell.
They engulf the cell by phagocytosis.
They stop protein synthesis in the target cell.
They produce granzymes that stimulate apoptosis.

A

They produce granzymes that stimulate apoptosis.

66
Q

Which is a distinguishing feature of a pre-B cell?

μ chains in the cytoplasm
Complete IgM on the surface
Presence of CD21 antigen
Presence of CD25 antigen

A

μ chains in the cytoplasm

67
Q

Where does the major portion of antibody production occur?

Peripheral blood
Bone marrow
Thymus
Lymph node

A

Lymph node

68
Q

A cell flow cytometry pattern belonging to a 3-year old patient showed the following: normal CD4+ T-cell count, normal CD19+ B-cell count, low CD8+ T-cell count. Which type of immunity would be affected?

Production of antibody
Formation of plasma cells
Elimination of virally infected cells
Downregulation of the immune response

A

Elimination of virally infected cells

69
Q

Which of the following is a unique characteristic of adaptive immunity?

Ability to fight infection
Ability to remember a prior exposure to a pathogen
A similar response to all pathogens encountered
Process of phagocytosis to destroy a pathogen

A

Ability to remember a prior exposure to a pathogen

70
Q

Discovery of genetic principles underlying the generation of antibodies with different specificities:

Edward Jenner
Ellie Metchnikoff
Emil von Behring
Susumu Tonegawa

A

Susumu Tonegawa

71
Q

Which of the following is characteristic of variable domains of immunoglobulins?

They occur on both the H and L chains
They represent the complement-binding site
They are at the carboxy-terminal ends of the molecules
They are found only on H chains

A

They occur on both the H and L chains

72
Q

Which antibody best protects mucosal surfaces?

IgA
IgD
IgG
IgM

A

IgA

73
Q

The subclasses of IgG differ mainly in:

Type of light chain
Arrangement of disulfide bonds
Ability to act as opsonin
Molecular weight

A

Arrangement of disulfide bonds

74
Q

Which antibody is best at agglutination and complement fixation?

IgA
IgG
IgD
IgM

A

IgM

75
Q

All of the following are true of IgE EXCEPT that it:

Fail to fix complement
Heat stable
Attaches to tissue mast cells
Found in the serum of allergic persons

A

Heat stable

IgE is the most heat-labile of all immunoglobulins; heating to 56°C for between 30 minutes and 3 hours results in conformational changes and loss of ability to bind to target cells.

76
Q

Papain digestion of an IgG molecule results in which of the following?

2 Fab’ and 1 Fc’ fragment
F(ab’)2 and 1 Fc’ fragment
2 Fab and 2 Fc fragments
2 Fab and 1 Fc fragment

A

2 Fab and 1 Fc fragment

Papain digestion yields two Fab fragments and an Fc portion.

Pepsin digestion yields an F(ab’)2 fragment with all the antibody activity, as well as an Fc′ portion.

77
Q

Which best characterizes the secondary response?

Equal amounts of IgM and IgG are produced
There is an increase in IgM only
There is a large increase in IgG but not IgM
The lag phase is the same as in the primary response

A

There is a large increase in IgG but not IgM

78
Q

A patient in septic shock caused by a gram-negative bacterial infection exhibits the following symptoms: high fever, very low blood pressure, and disseminated intravascular coagulation. Which cytokine is the most likely contributor to these symptoms?

IL-2
TNF
IL-12
IL-7

A

TNF

Tumor necrosis factor (TNF) secreted in response to gram-negative bacterial infections, causing a decrease in blood pressure, reduced tissue perfusion, and disseminated intravascular coagulation. The latter may lead to uncontrolled bleeding.

79
Q

Why might a colony stimulating factor be given to a cancer patient?

Stimulate activity of NK cells
Increase production of certain types of leukocytes
Decrease the production of TNF
Increase production of mast cells

A

Increase production of certain types of leukocytes

80
Q

A lack of C1-INH might result in which of the following conditions?

Paroxysmal nocturnal hemoglobinuria
Hemolytic uremic syndrome
Hereditary angioedema
Increased bacterial infections

A

Hereditary angioedema

81
Q

Which would be most effective in measuring an individual complement component?

CH50 assay
Radial immunodiffusion
AH50 assay
Lytic assay with liposome

A

Radial immunodiffusion

The methods most frequently used to measure individual components include radial immunodiffusion (RID) and nephelometry.

82
Q

Which technique represents a single-diffusion reaction?

Radial immunodiffusion
Ouchterlony diffusion
Immunoelectrophoresis
Immunofixation electrophoresis

A

Radial immunodiffusion

83
Q

Tiny agglutinates turbid background:

0
W+
1+
2+
3+
4+

A

W+

0 No agglutination or hemolysis
W+ Tiny agglutinates, turbid background
1+ Small agglutinates, turbid background
2+ Medium-sized agglutinates, clear background
3+ Several large agglutinates, clear background
4+ One solid agglutinate

84
Q

A few isolated aggregates; mostly free-floating cells; supernatant appears red:

Negative
Mixed-field
Weak
1+

A

Mixed-field

Grading Agglutination Reactions
Negative No aggregates
Mixed-field A few isolated aggregates; mostly free-floating cells; supernatant appears red
Weak (±) Tiny aggregates barely visible macroscopically; many free erythrocytes; turbid and reddish supernatant
1+ A few small aggregates just visible macroscopically; many free erythrocytes; turbid and reddish supernatant
2+ Medium-sized aggregates; some free erythrocytes; clear supernatant
3+ Several large aggregates; some free erythrocytes; clear supernatant
4+ All erythrocytes are combined into one solid aggregate; clear supernatant

85
Q

Several large aggregates; some free erythrocytes; clear supernatant:

1/1
1+
2+
3+
4+

A

3+

86
Q

An HLA specimen is collected in a tube containing:

ACD
EDTA
Silica
Thrombin

A

ACD

87
Q

Which technique involves probe amplification rather than target amplification?

Southern blot
PCR
Transcription-mediated amplification
Ligase chain reaction

A

Ligase chain reaction

88
Q

Forward-angle light scatter is an indicator of cell:

Granularity
Density
Size
Number

A

Size

Scattered light in a forward direction is a measure of cell size, whereas the side scatter determines a cell’s internal complexity, or granularity.

89
Q

If an analyzer gets different results each time the same sample is tested, what type of problem does this represent?

Sensitivity
Specificity
Accuracy
Precision

A

Precision

90
Q

It is considered the gold standard in testing for contact dermatitis:

RIST
RAST
Tuberculin test
Patch test

A

Patch test

The patch test is considered the gold standard in testing for contact dermatitis.

91
Q

Which of the following would be considered a significant finding in Graves disease?

Increased TSH levels
Antibody to TSH receptors
Decreased T3 and T4
Antithyroglobulin antibody

A

Antibody to TSH receptors

92
Q

A 20-year-old woman made an appointment to see her physician because she was experiencing intermittent diarrhea. Laboratory testing revealed that she also had an iron deficiency anemia. To determine if the patient has CELIAC DISEASE, her doctor should order which of the following laboratory tests?

Anti-tTG
Antigliadin
Antigluten
All of the above

A

Anti-tTG

CELIAC DISEAS: ANTIBODIES TO TISSUE TRANSGLUTAMINASE (tTG)
Currently, detection of IgA antibodies to tTG is the serological method of
choice for initial testing.

93
Q

Antimitochondrial antibodies are strongly associated with which disease?

Autoimmune hepatitis
Celiac disease
Primary biliary cirrhosis
Goodpasture’s syndrome

A

Primary biliary cirrhosis

94
Q

Antigen receptors on T lymphocytes bind HLA class II+ peptide complexes with the help of which accessory molecule?

CD2
CD3
CD4
CD8

A

CD4

95
Q

The only blood group system that affects clinical transplantation:

ABO
Rh
Kell
Duffy

A

ABO

The ABO system is the only blood group system that affects clinical transplantation.

96
Q

The best use of serum tumor markers is considered to be in:

Screening for cancer
Initial diagnosis of cancer
Monitoring patients undergoing cancer treatment
Determining patient prognosis

A

Monitoring patients undergoing cancer treatment]

Tumor markers are best used to monitor patient response to therapy by performing serial measurements over time.

If therapy is effective, the amount of tumor marker will decrease. Ineffective therapy and recurrence of cancer is indicated by an increase in the tumor marker level. Ideally, these increases would precede other signs of disease recurrence by several months.

97
Q

A woman with breast cancer is treated with a monoclonal antibody to HER2. This is an example of:

A cancer vaccine
An immunotoxin
Passive immunotherapy
Active immunotherapy

A

Passive immunotherapy

98
Q

What clinical manifestation would be seen in a patient with myeloperoxidase deficiency?

Defective T-cell function
Inability to produce IgG
Defective NK cell function
Defective neutrophil function

A

Defective neutrophil function

99
Q

A patient with a deficiency in complement component C7 would likely present with:

Recurrent Staphylococcal infections
Recurrent Neisserial infections
Recurrent Escherichia coli infections
Recurrent Nocardia infections

A

Recurrent Neisserial infections

100
Q

ecurrent, periodic fevers may be associated with increased production of which immunoglobulin?

IgG
IgM
IgD
IgE

A

IgD

Hyper IgD syndrome, also referred to as periodic fever syndrome, and Muckle-Wells syndrome.

Hyper IgD is caused by a deficiency of mevalonate kinase, an enzyme involved in a sterol synthesis pathway. The syndrome has been seen primarily in northern European populations.

101
Q

Characteristics of a bacterial capsule include which of the following?

It cannot be used for vaccine development
It is composed of peptidoglycan
It is an important mechanism for protecting a bacterium against ingestion by PMNs
It is what causes bacteria to stain as gram-negative

A

It is an important mechanism for protecting a bacterium against ingestion by PMNs

One of the most important features of a capsule is its role in blocking phagocytosis by WBCs.

102
Q

False-positive nontreponemal tests for syphilis may occur because of which of the following?

Infectious mononucleosis
Systemic lupus erythematosus
Pregnancy
All of these

A

All of these

103
Q

Which test is recommended for testing cerebrospinal fluid for detection of neurosyphilis?

RPR
VDRL
FTA-ABS
Enzyme immunoassay

A

VDRL

A positive VDRL test on spinal fluid is diagnostic of neurosyphilis because false positives are extremely rare.

104
Q

An RPR test done on a 19-year-old woman as part of a prenatal workup was negative but exhibited a rough appearance. What should the technologist do next?

Report the result out as negative.
Do a VDRL test
Send the sample for confirmatory testing.
Make serial dilutions and do a titer.

A

Make serial dilutions and do a titer.

Testing of sera from patients in the secondary stage is subject to false negatives because of the prozone phenomenon (antibody excess). In this case, a nonreactive pattern that is typically granular or rough in appearance is seen.

If a prozone is suspected, serial twofold dilutions of the patient’s sera should be made to obtain a titer.

105
Q

Suppose an individual develops antibodies in response to a streptococcal pharyngitis infection. This is an example of:

Active immunity
Passive immunity
Adoptive immunity
Immunoprophylaxis

A

Active immunity

106
Q

Protection from smallpox could be generated by the transfer of pustular material from cowpox lesion instead of the more hazardous smallpox lesion:

Edward Jenner
Louis Pasteur
Jules Bordet
Robert Kaus

A

Edward Jenner

107
Q

What was one of the major contributions of Louis Pasteur to vaccine development?

Development of the smallpox vaccine
Use of attenuated microorganisms in vaccines
Inactivation of bacterial toxins for vaccines
Discovery of recombinant vaccine antigens

A

Use of attenuated microorganisms in vaccines

Louis Pasteur used the principle of attenuation, or weakened microorganisms, to produce vaccines against chicken cholera, anthrax, and rabies.

108
Q

The antigenic component of the hepatitis B vaccine differs from those of many of the conventional vaccines in that it consists of a:

Live, attenuated virus
Inactivated virus
Cryptic antigen
Recombinant antigen

A

Recombinant antigen

Hepatitis A vaccine - inactivated vaccine
Hepatitis B vaccine - recombinant antigen

109
Q

The antigenic component of the hepatitis B vaccine differs from those of many of the conventional vaccines in that it consists of a:

Live, attenuated virus
Inactivated virus
Cryptic antigen
Recombinant antigen

A

Recombinant antigen

Hepatitis A vaccine - inactivated vaccine
Hepatitis B vaccine - recombinant antigen

110
Q

Plays an important role in protecting the kidney from damage and in preventing the loss of iron by urinary excretion:

Alpha1-antitrypsin
Ceruloplasmin
Haptoglobin
Fibrinogen

A

Haptoglobin

111
Q

Serves to promote aggregation of red blood cells, and increased levels contribute to an increased risk for developing coronary artery disease, especially in women:

Alpha1-antitrypsin
Ceruloplasmin
Haptoglobin
Fibrinogen

A

Fibrinogen

112
Q

A deficiency can result in premature emphysema, especially in individuals who smoke or who are exposed to a noxious occupational environment:

Alpha1-antitrypsin
Ceruloplasmin
Haptoglobin
Fibrinogen

A

Alpha1-antitrypsin

113
Q

Acute phase reactants elevated up to 1000x in inflammation:

CRP and ceruloplasmin
CRP and serum amyloid
Ceruloplasmin and fibrinogen
Ceruloplasmin and haptoglobin

A

CRP and serum amyloid

114
Q

CRP is produced by the:

Kidney
Liver
Bone marrow
Thymus

A

Liver

Produced by the liver under the control of IL-6, CRP is a parameter of inflammatory activity.

115
Q

All tissue macrophages arise from:

B lymphocytes
Basophils
Neutrophils
Monocytes

A

Monocytes

116
Q

Considered the most effective antigen-presenting cells (APCs):

T cells
Macrophages
Neutrophils
Dendritic cells

A

Dendritic cells

Dendritic cells, however, are considered the most effective APC in the body, as well as the most potent phagocytic cell.

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