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IS Flashcards

1
Q

Skin pH that keeps most microorganisms from growing:
A. 5.6
B. 6.5
C. 7.2
D. 8.0

A

A. 5.6

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2
Q

Primary function of the eosinophil:
A. Phagocytosis
B. Suppression of the inflammatory response
C. Reacting in acute, systemic hypersensitivity reactions
D. Antigen recognition

A

B. Suppression of the inflammatory response

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3
Q

Interferons (IFN) have been demonstrated to act as:
A. Immunomodulators
B. Antiviral agents
C. Antineoplastic agents
D. All of these

A

D. All of these

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4
Q

The process of inflammation is characterized by all of the following except:
A. Increased blood supply to the area
B. Migration of white blood cells
C. Decreased capillary permeability
D. Appearance of acute-phase reactants

A

C. Decreased capillary permeability

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5
Q

Acute-phase reactants are produced primarily by:
A. Endothelial cells
B. Epithelial cells
C. Fibroblasts
D. Hepatocytes (liver parenchymal cells)

A

D. Hepatocytes

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6
Q

The acute phase reactant that has the fastest response time and can rise 100x is:
A. Alpha-1 antitrypsin
B. Haptoglobin
C. C-reactive protein
D. Ceruloplasmin

A

C. C-reactive protein

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7
Q

Measurement of CRP levels can be used for all of the following except:
A. Monitoring drug therapy with anti-inflammatory agents
B. Tracking the normal progress of surgery
C. Diagnosis of a specific bacterial infection

A

C. Diagnosis of a specific bacterial infection

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8
Q

In plasma, this acute phase reactant is associated with HDL cholesterol, and it is thought to play a role in metabolism of cholesterol:
A. CRP
B. Ceruloplasmin
C. Haptoglobin
D. Serum amyloid

A

D. Serum amyloid

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9
Q

Hypochlorite and hydroxyl ions damage____ irreversibly, occur in the oxygen-dependent phase of phagocytosis.
A. DNA
B. Carbohydrate
C. Lipid
D. Protein

A

D. Protein

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10
Q

Neutrophil phagocytosis and particle ingestion are associated with an increase in oxygen utilization called respiratory burst. What are the two most important products of this biochemical reaction?
A. Hydrogen peroxide and superoxide anion
B. Lactoferrin and NADPH oxidase
C. Cytochrome b and collagenase
D. Alkaline phosphatase and ascorbic acid

A

D. Alkaline phosphatase and ascorbic acid

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11
Q

Which is the most significant agent formed in the phagolysosome for the killing of microorganisms?
A. Proteolytic enzymes
B. Hydroxyl radicals
C. Hydrogen peroxide
D. Superoxides

A

C. Hydrogen peroxide

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12
Q

Which is the most significant agent formed in the phagolysosome for the elimination of microorganisms?
A. Proteolytic enzymes
B. Hydrogen ions
C. Hypochlorite ions
D. Superoxides

A

C. Hypochlorite ions

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13
Q

A DPT vaccination is an example of:
A. Active humoral-mediated immunity
B. Passive humeral-mediated immunity
C. Cell-mediated immunity
D. Immediate hypersensitivity

A

A. Active humoral-mediated immunity

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14
Q

Which of the following cell surface molecules is classified as an MHC class Il antigen?
A. HLA-A
B. HLA-B
C. HLA-C
D. HLA-DR

A

D. HLA-DR

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15
Q

Antigen receptors on T lymphocytes bind HLA class II molecules with the help of which accessory molecule?
A. CD2
B. CD3
C. CD4
D. CD8

A

C. CD4

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16
Q

What molecule on the surface of most T cells recognizes antigen?
A. IgT
B. MHC protein
C. CD3
D. TcR

A

D. TcR

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17
Q

The main function of T cells in the immune response is to:
A. Produce cytokines that regulate both innate and adaptive immunity
B. Produce antibodies
C. Participate actively in phagocytosis
D. Respond to target cells without prior exposure

A

A. Produce cytokines that regulate both innate and adaptive immunity

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18
Q

Which cluster of differentiation (CD) marker appears during the first stage of T-cell development and remains present as an identifying marker for T cells?
A. CD1
B. CD2
C. CD3
D. CD4 or CD8

A

B. CD2

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19
Q

Which cluster of differentiation is MOST SPECIFIC identifying marker for mature T cells?
A. CD1
B. CD2
C. CD3
D. CD4 or CD8

A

C. CD3

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20
Q

Less expensive to perform and is of historic significance, because this represents the first means of T-cell identification:
A. Monoclonal antibodies
B. Flow cytometry
C. Rosette test
D. None of these

A

C. Rosette test

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21
Q

This T cell defect is a congenital anomaly that represents faulty embryogenesis, which results in aplasia of the parathyroid and thymus glands:
A. DiGeorge syndrome
B. Ataxia telangiectasia
C. Bruton agammaglobulinemia
D. Wiskott-Aldrich syndrome

A

A. DiGeorge syndrome

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22
Q

In testing for DiGeorge’s syndrome, what type of laboratory analysis would be most helpful in determining the number of mature T cells?
A. Complete blood count
B. Nitroblue tetrazolium (NBT) test
C. T-cell enzyme assays
D. Flow cytometry

A

D. Flow cytometry

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23
Q

A transplant patient began to show signs of rejection
8 days after receipt of the transplanted organ, and the organ was removed. What immune elements might be found in the rejected organ?
A. Antibody and complement
B. Primarily antibody
C. Macrophages
D. Tcells

A

D. Tcells

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24
Q

Patients at risk for graft-versus-host disease (GHD)
include each of the following, EXCEPT recipients of:
A. Bone marrow transplants
B. Lung transplants
C. Liver transplants
D. Irradiated leukocytes

A

D. Irradiated leukocytes

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25
Q

Marginal B cells remain in the:
A. Bone marrow
B. Lymph nodes
C. Spleen
D. Thymus

A

C. Spleen

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26
Q

Which of the following is the most common humoral immune deficiency disease?
A. Bruton agammaglobulinemia
B. Selective IgA deficiency
C. IgG deficiency
D. Wiskott-Aldrich syndrome

A

B. Selective IgA deficiency

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27
Q

An 18-month-old boy has recurrent sinopulmonary infections and septicemia. Bruton’s X-linked immunodeficiency syndrome is suspected. Which test result would be markedly decreased?
A. Serum IgG, IgA, and IgM
B. Total T-cell count
C. Both B- and T-cell counts
D. Lymphocyte proliferation with phytohemagglutinin stimulation

A

A. Serum IgG, IgA, and IgM

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28
Q

Macrophages produce which of the following proteins during antigen processing?
A. IL-1 and IL-6
B. y-Interferon
C. IL-4, IL-5, and IL-10
D. Complement components C1 and C3

A

A. IL-1 and IL-6

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29
Q

Which of the following best describes a HAPTEN?
A. Not able to react with antibody
B. Antigenic only when coupled to a carrier
C. Has multiple determinant sites
D. A large chemically complex molecule

A

B. Antigenic only when coupled to a carrier

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30
Q

Haptenic determinant will react with:
A. Both T cells and antibody
B. Tcells but not antibody
C. Neither T cells nor antibody
D. Antibody but not T cells

A

D. Antibody but not T cells

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31
Q

A synonym for an ANTIGENIC DETERMINANT is:
A. Immunogen
B. Epitope
C. Binding site
D. Polysaccharide

A

B. Epitope

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32
Q

UNIQUE AMINO ACID SEQUENCE THAT IS COMMON TO ALL IMMUNOGLOBULIN MOLECULES of a given class in a given species:
A. Isotype
B. Allotype
C. Idiotype
D. Any of these

A

A. Isotype

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33
Q

Antibody class/isotype and antibody subclass are determined by major physiochemical differences and antigenic variation found primarily in the:

A. Constant region of heavy chain
B. Constant region of light chain
C. Variable regions of heavy and light chains
D. Constant regions of heavy and light chains

A

A. Constant region of heavy chain

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34
Q

Antibody allotype is determined by the:
A. Constant region of heavy chain
B. Constant region of light chain
C. Variable regions of heavy and light chains
D. Constant regions of heavy and light chains

A

D. Constant regions of heavy and light chains

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35
Q

Antibody idiotype is dictated by the:
A. Constant region of heavy chain
B. Constant region of light chain
C. Variable regions of heavy and light chains
D. Constant regions of heavy and light chains

A

C. Variable regions of heavy and light chains

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36
Q

The ratio of kappa to lambda light chain-producing cells in normal individuals is:
A. 1:1
B. 2:1
C. 3:1
D. 4:1

A

B. 2:1

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37
Q

All of the following are functions of immunoglobulins 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

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38
Q

Treatment of IgG with papain results in how many fragments from each immunoglobulin molecule?
A. 2
в. 3
C. 4
D. 5

A

в. 3

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39
Q

Which of the following immunoglobulins is present in the highest concentration in normal human serum?
A. IgM
B. IgG
C. IgA
D. IgE

A

B. IgG

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40
Q

The key structural difference that distinguishes immunoglobulin subclasses is the:
A. Number of domains
B. Stereometry of the hypervariable region
C. The sequence of the constant regions
D. Covalent linkage of the light chains

A

C. The sequence of the constant regions

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41
Q

The SUBCLASSES of IgG differ mainly in:
A. Type of L chain
B. Arrangement of disulfide bonds
C. Ability to act as opsonins
D. Molecular weight

A

B. Arrangement of disulfide bonds

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42
Q

Which IgG subclass is most efficient at crossing the placenta?
A. IgG1
B. IgG2
C. IgG3
D. IgG4

A

A. IgG1

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43
Q

Which antibody is best at agglutination and complement fixation?
A. IgA
B. IgG
C. IgD
D. IgM

A

D. IgM

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44
Q

Which of the following statements about IgM is false?
A. Composed of five basic subunits
B. More efficient in the activation of the complement cascade and agglutination than IgG
C. Predominant in an initial antibody response
D. Predominant in a secondary (anamnestic) response

A

D. Predominant in a secondary (anamnestic) response

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45
Q

Which best describes the role of the SC of IgA? secretory comp
A. A transport mechanism across endothelial cells
B. A means of joining two IgA monomers together
C. An aid to trapping antigen
D. Enhancement of complement fixation by the classical pathway

A

A. A transport mechanism across endothelial cells

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46
Q

Which represents the main function of IgD?
A. Protection of the mucous membranes
B. Removal of antigens by complement fixation
C. Enhancing proliferation of B cells
D. Destruction of parasitic worms

A

C. Enhancing proliferation of B cells

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47
Q

All of the following are immunologic functions of complement except:
A. Induction of an antiviral state
B. Opsonization
C. Chemotaxis
D. Anaphylatoxin formation

A

A. Induction of an antiviral state

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48
Q

Which region determines whether an immunoglobulin molecule can fix complement?
A. VH
B. CH
C. VL
D. CL

A

B. CH

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49
Q

Which of the following statements is false about an anamnestic response versus a primary response?
A. Has a shorter lag phase
B. Has a longer plateau
C. Antibodies decline more gradually
D. IgM antibodies predominate

A

D. IgM antibodies predominate

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50
Q

In a secondary (anamnestic) response, all the following characteristics are correct except:

A. IgG is the predominant antibody type
B. It has a shorter lag phase
C. The antibody titer is lower
D. It has a more gradual decline in antibody response

A

C. The antibody titer is lower

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51
Q

Most plasma complement proteins are synthesized in the LIVER with the exception of:

A. C1 and Factor B
B. C1 and Factor D
C. C3 and Factor B
D. C3 and Factor D

A

B. C1 and Factor D

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52
Q

Which complement component is present in the greatest quantity in plasma?

A. 2
B. 3
C. 4
D. 8

A

B. 3

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53
Q

The three complement activation pathways converge at the point of cleavage of complement component:
A. C3
B. C5
C. C7
D. C8

A

A. C3

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54
Q

Which of the following releases histamine and other mediators from basophils?
A. C3a
B. Properdin factor B
C. C1q
D. C4

A

A. C3a

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55
Q

Which of the following complement components is a strong CHEMOTACTIC FACTOR as well as a strong ANAPHYLATOXIN?
A. C3a
B. C3b
C. C5a
D. C4a

A

C. C5a

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56
Q

Which of the following activities is associated with C3b?

A. Opsonization
B. Anaphylaxis
C. Vasoconstriction
D. Chemotaxis

A

A. Opsonization

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57
Q

Mannose-binding protein in the lectin pathway is most similar to which classical pathway component?
A. C3
B. C1rs
C. C1q
D. C4

A

C. C1q

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58
Q

Complement can be inactivated in human serum by heating to_____ °C.
A. 25
B. 37
C. 45
D. 56

A

D. 56

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59
Q

A specimen should be reinactivated when more than _____________hour(s) has (have) elapsed since inactivation.
A. 1
B. 2
C. 4
D. 8

A

C. 4

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60
Q

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

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61
Q

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

A

B. Loss of tolerance to self-antigens

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62
Q

Laboratory features of SLE include:

A. The presence of ANAs
B. Circulating anticoagulant and immune complexes
C. Decreased levels of complement
D. All of the above

A

D. All of the above

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63
Q

What disease is indicated by a high titer of anti-Sm (anti-Smith) antibody?
A. Mixed connective tissue disease (MCTD)
B. RA
C. SLE
D. Scleroderma

A

C. SLE

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64
Q

Which immunofluorescence pattern indicates the need for ENA testing by Ouchterlony immunodiffusion, Multiplex, or ELISA assays?

A. Homogeneous or solid
B. Peripheral or rim
C. Speckled
D. Nucleolar

A

C. Speckled

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65
Q

Rheumatoid factor is most often of which of the following classes:
A. IgE
B. IgA
C. IgM
D. IgG

A

C. IgM

66
Q

Rheumatoid factor consists of antibodies that bind the:
A. Fc portion of IgG molecule
B. Fab portion of IgG molecule
C. Fc portion of IgM molecule
D. Fab portion of IgM molecule

A

A. Fc portion of IgG molecule

67
Q

A patient with joint swelling and pain tested negative for serum RF by both latex agglutination and ELISA methods. What other test would help establish a diagnosis of RA in this patient?

A. Anti-CCP
B. ANA testing
C. Flow cytometry
D. Complement levels

A

A. Anti-CCP

68
Q

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

69
Q

In PRIMARY BILIARY CIRRHOSIS, which of the following antibodies is seen in high titers?

A. Antimitochondrial
B. Anti-smooth muscle
C. Anti-DNA
D. Anti-parietal cell

A

A. Antimitochondrial

70
Q

Which disease might be indicated by antibodies to smooth muscle?

A. Atrophic gastritis
B. Autoimmune hepatitis
C. Myasthenia gravis
D. Sjögren’s syndrome

A

B. Autoimmune hepatitis

71
Q

Antibodies to thyroid peroxidase can be detected by using agglutination assays. Which of the following diseases may show positive results with this type of assay?

A. Graves’ disease and Hashimoto’s thyroiditis
B. Myasthenia gravis
C. Granulomatous thyroid disease
D. Addison’s disease

A

A. Graves’ disease and Hashimoto’s thyroiditis

72
Q

In Grave’s disease, one of the main autoantibodies is:

A. Anti-CCP
B. Antibody to islet cells of pancreas
C. Antibody to thyroid-stimulating hormone receptor
D. Anti-dsDNA

A

C. Antibody to thyroid-stimulating hormone receptor

73
Q

HLA-B8 ANTIGEN has been associated with which of the following pairs of diseases?

A. Ankylosing spondylitis and myasthenia gravis
B. Myasthenia gravis and celiac disease
C. Celiac disease and akylosing spondylitis
D. Reiter disease and multiple sclerosis

A

B. Myasthenia gravis and celiac disease

74
Q

Which immunologic mechanism is usually involved in BRONCHIAL ASTHMA?

A. Immediate hypersensitivity
B. Immune complex
C. Antibody mediated cytotoxicity
D. Delayed hypersensitivity

A

A. Immediate hypersensitivity

75
Q

After a PENICILLIN injection, a patient rapidly develops respiratory distress, vomiting and hives. This reaction is primarily mediated by:

A. IgG
B. IgA
C. IgM
D. IgE

A

D. IgE

76
Q

In skin tests, WHEAL AND FLARE development is indicative:

A. Immediate hypersensitivity
B. Anergy
C. Delayed hypersensitivity
D. Arthus reaction

A

A. Immediate hypersensitivity

77
Q

Which test would measure the coating of red cells by antibody as occurs in hemolytic transfusion reactions?

A. Indirect antiglobulin test (IAT)
B. Direct antiglobulin test (DAT)
C. ELISA
D. Hemagglutination

A

B. Direct antiglobulin test (DAT)

78
Q

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

A. Insufficient washing of RBCs

79
Q

Type III reactions are exemplified by all the following except:

A. Arthus reaction
B. Serum sickness
C. Glomerulonephritis
D. Shingles

A

D. Shingles

80
Q

Which test is used to evaluate the cellular immune system in a patient?

A. Skin test for commonly encountered antigens
B. Determination of isohemagglutinin titer
C. Immunoelectrophoresis of serum
D. Lymphocyte proliferation to mitogen/antigen

A

A. Skin test for commonly encountered antigens

81
Q

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

A

B. T cells and macrophages

82
Q

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 to 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 to 4°C for several hours, then remove serum

83
Q

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

84
Q

What is the “M” component in monoclonal gammopathies?

A. IgM produced in excess
Β. μ Heavy chain produced in excess
C. Malignant proliferation of B cells
D. Monoclonal antibody or cell line

A

D. Monoclonal antibody or cell line

85
Q

The most common application of IEP of serum is for the:

A. Diagnosis of monoclonal gammopathy
B. Diagnosis of polyclonal gammopathy
C. Diagnosis of autoimmune hemolysis
D. Demonstration of Bence Jones (BJ) protein

A

A. Diagnosis of monoclonal gammopathy

86
Q

The most important application of IEP of urine is: a.

A. Diagnosis of monoclonal gammopathy
B. Diagnosis of polyclonal gammopathy
C. Diagnosis of autoimmune hemolysis
D. Demonstration of Bence Jones (BJ) protein

A

D. Demonstration of Bence Jones (BJ) protein

87
Q

Patients with Waldenström’s macroglobulinemia exhibit abnormally large amounts of:

A. IgM
B. IgG
C. IgE
D. IgA

A

A. IgM

88
Q

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

89
Q

Which of the following type(s) of bonding is (are) involved in antigen-antibody reactions?

A. Hydrophobic
B. Hydrogen
C. Van der Waals
D. All of the above

A

D. All of the above

90
Q

Bonding of antigen to antibody exists exclusively as:

A. Hydrogen bonding
B. Van der Waals forces
C. Electrostatic forces
D. Noncovalent bonding

A

D. Noncovalent bonding

91
Q

Which of the following describes an antigen antibody reaction?

A. The reaction is reversible
B. The reaction is the same as a chemical reaction
C. A lattice is formed at prozone
D. A lattice is formed at postzone

A

A. The reaction is reversible

92
Q

When soluble antigens diffuse in a gel that contains antibody, in which zone does optimum precipitation occur?

A. Prozone
B. Zone of equivalence
C. Postzone
D. Prezone

A

B. Zone of equivalence

93
Q

A soluble antigen and soluble antibody reacting to form an insoluble product describes

A. Agglutination reactions
B. Heterophile reactions
C. Labeled reactions
D. Precipitation reactions

A

D. Precipitation reactions

94
Q

Which of the following is the most common application of IMMUNOELECTROPHORESIS (IEP)?

A. Identification of the absence of a normal serum
protein
B. Structural abnormalities of proteins
C. Screening for circulating immune complexes
D. Diagnosis of monoclonal gammopathies

A

D. Diagnosis of monoclonal gammopathies

95
Q

In FPIA, labeled antigens compete with unlabeled antigen in the patient sample for a limited number of antibody binding sites. The MORE antigen that is present in the patient sample:

A. Less fluorescence
B. Greater fluorescence
C. Less fluorescence polarization
D. Greater fluorescence polarization

A

C. Less fluorescence polarization

96
Q

MAJOR SYSTEMS IN A FLOW CYTOMETER include all of the following except: TURGEON

A. Fluidics
B. Optics
C. Computerized electronics
D. Gating

A

D. Gating

97
Q

Flow cytometry characterizes cells on the basis of which of the following?

A. Forward and 90-degree side scatter of an interrupted beam of light
B. Front-angle scatter only of an interrupted light beam
C. Absorbance of light by different types of cells
D. Transmittance of light by cells in solution

A

A. Forward and 90-degree side scatter of an interrupted beam of light

98
Q

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

99
Q

What is the immunologic method utilized in the FLOW CYTOMETER?

A. Latex agglutination
B. Immunofluorescence
C. Enzyme linked immunoassay
D. Radioimmunoassay

A

B. Immunofluorescence

100
Q

What temperature is used to achieve DNA denaturation to a single strand?

A. 74 °C
B. 92 °C
C. 94 °C
D. 102 °C

A

C. 94 °C

101
Q

What is the lowest level of hormone for which most current serum hCG tests can give a positive result?

A. 25 mIU/mL
B. 50 mIU/mL
C. 100 mIU/mL
D. 200 mIU/mL

A

A. 25 mIU/mL

102
Q

In the card pregnancy test, if the test band appears very faint, it is recommended that it is:

A. Reported as positive
B. Reported as negative
C. Test is considered invalid
D. New sample collected 48 hours later and tested

A

D. New sample collected 48 hours later and tested

103
Q

Direct examination of the treponemes:

A. Light microscopy
B. Darkfield microscopy
C. VDRL testing
D. RPR testing

A

B. Darkfield microscopy

104
Q

Which serum antibody response usually characterizes the primary (early) stage of syphilis?

A. Antibodies against syphilis are undetectable
B. Detected 1 to 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 to 3 weeks after appearance of the primary chancre

105
Q

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

106
Q

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

107
Q

Speed and time of rotation for serum VDRL test:

A. 100 rpm for 4 minutes
B. 100 rpm for 8 minutes
C. 180 rpm for 4 minutes
D. 180 rpm for 8 minutes

A

C. 180 rpm for 4 minutes

108
Q

Speed and time of rotation for CSF VDRL test:

A. 100 rpm for 4 minutes
B. 100 rpm for 8 minutes
C. 180 rpm for 4 minutes
D. 180 rpm for 8 minutes

A

D. 180 rpm for 8 minutes

109
Q

Speed and time of rotation for RPR:
A. 100 rpm for 4 minutes
B. 100 rpm for 8 minutes
C. 180 rpm for 4 minutes
D. 180 rpm for 8 minutes

A

B. 100 rpm for 8 minutes

110
Q

In the RPR test, what is the gauge of the needle for antigen delivery?

A. 16
B. 18
C. 20
D. 21

A

C. 20

111
Q

A widely used HEMAGGLUTINATION test for detecting antibody to Treponema pallidum is:

A. MHA-TP test
B. FTA-ABS test
C. VDRL test
D. TPI test

A

A. MHA-TP test

112
Q

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

A. RPR
B. VDRL
C. FTA-ABS
D. Enzyme immunoassay

A

B. VDRL

113
Q

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

114
Q

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

115
Q

A biological false-positive reaction is least likely with which test for syphilis?

A. VDRL
B. FTA-ABS
C. RPR
D. All are equally likely to detect a false-positive result

A

B. FTA-ABS

116
Q

Which of the following is the most sensitive test to detect congenital syphilis?

A. VDRL
B. RPR
C. Microhemagglutination test for T. pallidum (МНА-ТР)
D. Polymerase chain reaction (PCR)

A

D. Polymerase chain reaction (PCR)

117
Q

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

118
Q

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

119
Q

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

A. 200 Todd units
B. 240 Todd units
C. 320 Todd units
D. 340 Todd units

A

B. 240 Todd units

120
Q

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

A. 200 Todd units
B. 240 Todd units
C. 320 Todd units
D. 340 Todd units

A

C. 320 Todd units

121
Q

What is the endpoint for the antistreptolysin O (ASO) latex agglutination assay? signicant titer: 200 IU//ML

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

122
Q

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)

123
Q

Which of the following was a surrogate test for hepatitis that is no longer required?
A. ALT
B. Anti-HBc
C. CMV
D. HBsAg

A

A. ALT

124
Q

The first serologic marker to appear in patients with acute hepatitis B virus infection is

A. Anti-HBs
B. Anti-HBc
C. Anti-HBe
D. HBsAg

A

D. HBsAg

125
Q

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

126
Q

Which surface marker is a reliable marker for the presence of high levels of hepatitis B virus (HBV) and a high degree of infectivity?

A. HBe Ag
B. HBs Ag
C. HBc Ag
D. Anti-HBsAg

A

A. HBe Ag

127
Q

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

128
Q

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

129
Q

What assay would confirm the immune status of the hepatitis B virus?

A. HBsAg
B. Anti-HBs
C. IgM anti-HBcAg
D. Hepatitis C Ag

A

B. Anti-HBs

130
Q

A hospital employee received the final dose of the hepatitis B vaccine 3 weeks ago. She wants to donate blood. Which of the following results are expected from the hepatitis screen, and will she be allowed to donate blood?

A. HBsAg, positive; anti-HBc, negative; she may donate
B. HBsAg, negative; anti-HBc, positive; she may not donate
C. HBsAg, positive; anti-HBc, positive; she may not donate
D. HBsAg, negative; anti-HBc, negative; she may donate

A

D. HBsAg, negative; anti-HBc, negative; she may donate

131
Q

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

132
Q

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

133
Q

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

134
Q

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. D. They are quantitative

A

C. They detect p24 antigen

135
Q

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

A. gp120
B. gp160
C. gp41
D. p24

A

D. p24

136
Q

Which of the following combinations of bands would represent a positive Western blot for HIV antibody?

A. p24 and p55
B. p24 and p31
C. gp41 and gp120
D. p31 and p55

A

C. gp41 and gp120

137
Q

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

138
Q

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

139
Q

Which of the following tests is CURRENTLY RECOMMENDED BY THE CDC to confirm a positive screening test result for HIV infection?

A. Rapid test for HIV-1 and HIV-2 antibodies
B. Western blot
C. Molecular testing for HIV RNA
D. HIV viral culture

A

A. Rapid test for HIV-1 and HIV-2 antibodies

140
Q

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

141
Q

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

142
Q

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

143
Q

HTLV-I and HTLV-II can be transmitted by:

A. Bloodborne (transfusion, IV drug abuse)
B. Sexual contact (commonly from men to women)
C. Mother-to-child (mainly through breastfeeding)
D. All of these

A

D. All of these

144
Q

Individuals exposed to EBV maintain an asymptomatic latent infection in:

A. B cells
B. T cells
C. All lymphocytes
D. Monocytes

A

A. B cells

145
Q

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

146
Q

Two cross-reacting antigen types of herpes simplex virus have been identified:

A. EBV and CMV
B. HHV6 and HHV7
C. VZV and CMV
D. HSV1 and HSV2

A

D. HSV1 and HSV2

147
Q

Cross-reactions in the complement fixation test for Histoplasma capsulatum occur in patients with _______but titers appear to be lower.
A. Aspergillosis
B. Blastomycosis
C. Aspergillosis, blastomycosis
D. Blastomycosis, aspergillosis, coccidiomycosis

A

D. Blastomycosis, aspergillosis, coccidiomycosis

148
Q

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

149
Q

LATEX AGGLUTINATION for cryptococcal is now recommended test for Cryptococcus neoformans.

A. Polysaccharide capsule
B. Antigen
C. Antibody
D. Nucleic acids

A

B. Antigen

150
Q

Serological testing provides the most practical and reliable means of confirming a measles diagnosis. Samples collected before_______ may yield false-negative results, and repeat testing on a later sample is recommended in that situation.
A. 72 hours
B. 5 days
C. 6 days
D. 9 days

A

A. 72 hours

151
Q

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)

152
Q

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

153
Q

In general, in which of the following situations is the analysis of a tumor marker most useful?

A. Testing for recurrence
B. Prognosis
C. Screening
D. Diagnosis

A

A. Testing for recurrence

154
Q

What is the primary clinical utility of measuring CEA?

A. Diagnosis of liver cancer
B. Diagnosis of colorectal cancer
C. Screening for cancers of endodermal origin
D. Monitoring for recurrence of cancer

A

D. Monitoring for recurrence of cancer

155
Q

Which type of cancer is associated with the highest level of AFP?

A. Hepatoma
B. Ovarian cancer
C. Testicular cancer
D. Breast cancer

A

A. Hepatoma

156
Q

Which tumor marker is associated with cancer of the urinary bladder?

A. CA-19-9
B. CA-72-4
C. Nuclear matrix protein
D. Cathepsin-D

A

C. Nuclear matrix protein

157
Q

A 55-year-old male with early stage prostate cancer diagnosed by biopsy had his prostate gland removed (simple prostatectomy). His PSA prior to surgery was 10.0 ng/mL. If the surgery was successful in completely removing the tumor cells, what would the PSA result be 1 month after surgery?

A. Undetectable
B. 1 to 3 ng/mL
C. Less than 4 ng/mL
D. Less than 10 ng/mL

A

A. Undetectable

158
Q

A patient has a prostate-specific antigen level of 60 ng/mL the day before surgery to remove a localized prostate tumor. One week following surgery, the serum PSA was determined to be 8 ng/mL by the same method. What is the most likely cause of these results?

A. Incomplete removal of the malignancy
B. Cross reactivity of the antibody with another tumor antigen
C. Testing too soon after surgery
D. Hook effect with the PSA assay

A

C. Testing too soon after surgery

159
Q

Which of the following statements regarding the Philadelphia chromosome is true?

A. It is seen exclusively in chronic myelogenous leukemia
B. It results from a translocation
C. It appears as a short-arm deletion of chromosome 21
D. It is associated with a poor prognosis

A

B. It results from a translocation

160
Q

A major advantage of POCT is:

A. Faster turnaround time
B. Lower cost
C. Better quality than traditional testing
D. Both A and C

A

A. Faster turnaround time

Suma (5 decks)

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