SEROLOGY CIULLA Flashcards
1
Q
- A major advantage of passive immunization compared to active immunization is that
A. Antibody is available more quickly
B. Antibody persists for the life of the
recipient
C. IgM is the predominant antibody class
provided
D. Oral administration can be used
A
A. Antibody is available more quickly
2
Q
- The strength with which a multivalent
antibody binds a multivalent antigen is
termed the
A. Affinity
B. Avidity
C. Reactivity
D. Valence
A
B. Avidity
3
Q
- How does the secondary humoral immune
response differ from the primary response?
A. The lag phase (the time between exposure to immunogen and production of antibody) is longer in the secondary immune response.
B. IgM is the predominant antibody class
produced in the secondary immune
response.
C. The antibody levels produced are higher in the secondary immune response.
D. Cytotoxic T lymphocytes play an important role in the secondary response.
A
C. The antibody levels produced are higher in the secondary immune response.
4
Q
- After activation of the complement
system, leukocytes and macrophages are
attracted to the site of complement
activation by
A. Cl
B. C5a
C. C8
D. IgM
A
B. C5a
5
Q
- The type of immunity that follows the
injection of an immunogen is termed
A. Artificial active
B. Natural active
C. Artificial passive
D. Innate
A
A. Artificial active
6
Q
- The type of immunity that follows the
injection of antibodies synthesized by
another individual or animal is termed
A. Artificial active
B. Natural adaptive
C. Artificial passive
D. Natural passive
A
C. Artificial passive
7
Q
- Innate immunity includes
A. Anamnestic response
B. Antibody production
C. Cytotoxic T cell activity
D. Phagocytosis by polymorphonuclear
cells
A
D. Phagocytosis by polymorphonuclear
cells
8
Q
- The agglutination pattern shown in Color Plate 23 * was observed while performing an antibody titration. This agglutination pattern is an example of
A. A prezone reaction
B. A prozone reaction
C. A postzone reaction
D. Incomplete complement inactivation
A
B. A prozone reaction
9
Q
- The antibody most frequently present in systemic lupus erythematosus is directed against
A. Surface antigens of bone marrow
stem cells
B. Surface antigens of renal cells
C. Nuclear antigen
D. Myelin
A
C. Nuclear antigen
10
Q
- The rapid plasma reagin assay for syphilis does not need to be read microscopically because the antigen is
A. Cardiolipin
B. Complexed with latex
C. Complexed with charcoal
D. Inactivated bacterial cells
A
C. Complexed with charcoal
11
Q
- The Venereal Disease Research Laboratory (VDRL) test for syphilis is classified as a(n)
A. Agglutination reaction
B. Flocculation reaction
C. Hemagglutination reaction
D. Precipitation reaction
A
B. Flocculation reaction
12
Q
- One cause of a false-positive VDRL test is
A. Brucellosis
B. Treponema pallidum infection
C. Rocky Mountain spotted fever
D. Systemic lupus erythematosus
A
D. Systemic lupus erythematosus
13
Q
- The portion of an antigen that binds to an antibody or T cell receptor is called a(n)
A. Allergin
B. Avidin
C. Epitope
D. Valence
A
C. Epitope
14
Q
- Identical antibodies produced from a
single clone of plasma cells describes
A. Reagin
B. Cold agglutinins
C. Heterophile antibodies
D. Monoclonal antibodies
A
D. Monoclonal antibodies
15
Q
- IgM antibodies react well in complement fixation (CF) tests. Because of this, CF tests for antibodies should
A. Be positive early in the course of the
disease
B. Be useful in identifying antibodies
responsible for a delayed hypersensitivity
reaction
C. Be useful in identifying antibodies
responsible for anaphylactic reactions
D. Detect transplacental antibodies
A
A. Be positive early in the course of the
disease
16
Q
- Which of the following serologic tests is
commonly performed by an immunofluorescence method?
A. Anti-HBs
B. Antinuclear antibody (ANA)
C. Antistreptolysin O (ASO)
D. C-reactive protein (CRP)
A
B. Antinuclear antibody (ANA)
17
Q
- The Fab portion of an antibody
A. Binds T cell receptor
B. Consists of two light chains only
C. Consists of two heavy chains only
D. Contains the hypervariable reagion
A
D. Contains the hypervariable reagion
18
Q
- In the enzyme-linked immunosorbent
assay (ELISA), the visible reaction is due
to a reaction between
A. Enzyme and antibody
B. Enzyme and substrate
C. Fluorescent dye and antigen
D. Latex particles and antibody
A
B. Enzyme and substrate
19
Q
- Elevated IgE levels are typically found in
A. Type I hypersensitivity reactions
B. Type II hypersensitivity reactions
C. Type III hypersensitivity reactions
D. Type IV hypersensitivity reactions
A
A. Type I hypersensitivity reactions
20
Q
- Loss of self-tolerance results in
A. Autoimmune disease
B. Graft-versus-host disease
C. Immunodeficiency
D. Tumors
A
A. Autoimmune disease
21
Q
- A human cell with CDS on its surface is
most likely a
A. Bcell
B. Monocyte
C. T helper cell
D. Cytotoxic T cell
A
D. Cytotoxic T cell
22
Q
- Which of the following statements about immunoglobulin light chains is true ?
A. Each immunoglobulin monomer has
either one kappa or one lambda chain.
B. There are two types: kappa and
lambda.
C. They consist of constant regions only.
D. They form part of the Fc fragment.
A
B. There are two types: kappa and
lambda.
23
Q
- Which of the following statements applies to the Fc fragment of an immunoglobulin molecule?
A. It consists of the entire heavy chain.
B. It contains the variable region of the
heavy chain.
C. It contains the antigen binding sites of
the molecule.
D. It is the region of the molecule that
binds to receptors on various white
blood cells.
A
D. It is the region of the molecule that
binds to receptors on various white
blood cells.
24
Q
- Monoclonal antibodies are produced by
A. Cultured T cells
B. Human plasma cells
C. Mouse plasma cells
D. Hybridomas
A
D. Hybridomas
25
Q
- Antibodies that bind to the same epitope are of the same
A. Allotype
B. Autotype
C. Idiotype
D. Isotype
A
C. Idiotype
26
Q
- Skin testing is a useful diagnostic tool in a number of disorders, such as tuberculosis. Which of the following statements about skin testing is true?
A. A positive test depends on preformed
antibody.
B. Reactivity to a particular antigen may
be transferred from one individual to
another by sensitized lymphocytes.
C. The intensity of the response correlates
directly with the clinical activity
of the disease.
D. The maximum response will occur
immediately.
A
B. Reactivity to a particular antigen may
be transferred from one individual to
another by sensitized lymphocytes.
27
Q
- The activity of natural killer (NK) cells
A. Does not require previous exposure to
an antigen
B. Involves phagocytosis and killing of
bacteria
C. Requires interaction with cytotoxic
T cells
D. Requires interaction with B cells
A
A. Does not require previous exposure to
an antigen
28
Q
- Interaction between B and T helper cells involves
A. MHC II molecule on B cell binding to
MHCI molecule on the T cell
B. MHC II molecule on B cell binding to
CDS on the T cell
C. Foreign antigen on B cell binding to
T cell receptor
D. CDS molecule on B cell binding to
T cell receptor
A
C. Foreign antigen on B cell binding to
T cell receptor
29
Q
- Which of the following is a characteristic of T cells?
A. Synthesize antibody
B. Mature in the thymus
C. Able to bind unprocessed antigen
D. Primarily protect against extracellular
parasites
A
B. Mature in the thymus
30
Q
- The primary mechanism responsible for pathology in systemic lupus erythematosus is
A. Allergic reaction to foreign molecules
B. Antibodies directed against self antigens
C. Polyclonal activation of cytotoxic T cells
D. Lack of intracellular killing after neutrophil phagocytosis of bacteria
A
B. Antibodies directed against self antigens
31
Q
- Which complement protein is present in
the greatest concentration in human
serum?
A. Cl
B. C2
C. C3
D. C4
A
C. C3
32
Q
- An autoimmune disease causing destruction of pancreatic cells can result in
A. Hashimoto disease
B. Multiple sclerosis
C. My asthenia gravis
D. Type 1 diabetes
A
D. Type 1 diabetes
33
Q
- An Ouchterlony gel diffusion plate is
depicted in Color Plate 24B. The center
well contains antibody, and the peripheral
wells contain antigens labeled 1 through 4.
What is the relationship between the
antigens in wells 2 and 3?
A. 2 is part of 3.
B. 3 is part of 2.
C. They are identical.
D. They are unrelated.
A
D. They are unrelated.
34
Q
- An Ouchterlony gel diffusion plate is
depicted in Color Plate 24B. The center well
contains antibody, and the peripheral wells
contain antigens labeled 1 through 4. What
is the relationship between the antigens in
wells 2 and 4?
A. Cannot be determined.
B. They are identical.
C. They are unrelated.
D. They react incompletely with the
antibody.
A
B. They are identical.
35
Q
- Which of the following complement
proteins is part of the membrane attack
complex?
A. Cl
B. C3
C. C4
D. C5
A
D. C5
36
Q
- Which of the following is characteristic of contact hypersensitivity reactions?
A. Caused by preformed IgE antibody
B. Characterized by infiltration of
neutrophils into the area of reaction
C. The primary symptoms often occur in
the respiratory tract.
D. Usually due to a hapten
A
D. Usually due to a hapten
37
Q
- Which of the following statements about the test for C-reactive protein (CRP) is true?
A. It correlates with neutrophil phagocytic
function.
B. It is an indicator of ongoing inflammation.
C. It is diagnostic for rheumatic fever.
D. Levels decrease during heart disease.
A
B. It is an indicator of ongoing inflammation.
38
Q
- In the classical pathway of complement
activation,
A. C3 is activated by binding C-reactive
protein
B. The sequence of activation is Cl, C2,
C3,C4
C. Clq is activated by the presence of
a single Fab region
D. Activation by antibody requires one
IgM or two IgG molecules
A
D. Activation by antibody requires one
IgM or two IgG molecules
39
Q
- The alternative complement pathway
A. Can be activated by bacterial capsule
polysaccharides
B. Uses C5b as a C3 convertase
C. Bypasses steps C3 through C5
D. Is inactivated by properdin
A
A. Can be activated by bacterial capsule
polysaccharides
40
Q
- A cut on a person’s finger becomes
contaminated with the bacterium
Staphylococcus aureus. The first
response by the immune system
consists of activity of
A. B cells
B. Monocytes
C. Neutrophils
D. T cells
A
C. Neutrophils
41
Q
- Incompatible blood transfusions are
examples of
A. Type I hypersensitivity reactions
B. Type II hypersensitivity reactions
C. Type III hypersensitivity reactions
D. Type IV hypersensitivity reactions
A
B. Type II hypersensitivity reactions
42
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
43
Q
- Which of the following is an example of a treponemal antigen test used for the
diagnosis of syphilis?
A. CRP
B. RPR
C. VDRL
D. FTA-ABS
A
D. FTA-ABS
44
Q
- A serum sample is positive for HBsAg.
This result indicates that the person from
whom the serum was taken
A. Had a hepatitis B infection in the past
but overcame the infection
B. Has either active or chronic hepatitis B
infection
C. Was immunized recently against the
hepatitis B virus
D. Is not infectious for the hepatitis B
virus
A
B. Has either active or chronic hepatitis B
infection
45
Q
- What is the indicator system used in the
complement fixation test?
A. Sensitized sheep red blood cells
B. Fluorescent-labeled antihuman
globulin
C. Enzyme-labeled antihuman globulin
D. Guinea pig complement
A
A. Sensitized sheep red blood cells
46
Q
- The isotype of an immunoglobulin antibody
A. Is defined by the heavy chain
B. Is defined as different alleles of the
same antibody type (e.g., IgG)
C. Is constant for all immunoglobulins of
an individual
D. Is the variation within the variable
region
A
A. Is defined by the heavy chain
47
Q
- A patient report states the presence of
serum antibodies to OspC. What disease
does the patient most likely have?
A. Syphilis
B. Strep throat
C. Lyme disease
D. Rubella
A
C. Lyme disease
48
Q
- Patient serum is mixed with a suspension of guinea pig antigen. When the sample is then mixed with horse red blood cells, agglutination occurs. This is suggestive of an infection caused by
A. Borrelia burgdorferi
B. Hepatitis B virus
C. Hepatitis C virus
D. Epstein-Barr virus
A
D. Epstein-Barr virus
49
Q
- Hashimoto disease is an autoimmune
disease primarily involving the
A. Kidneys
B. Liver
C. Lungs
D. Thyroid gland
A
D. Thyroid gland
50
Q
- Rheumatic fever sometimes occurs after group A streptococcal infections. In this condition, an autoimmune response
attacks the tissue of the heart valves. This
phenomenon is an example of
A. Epitope spreading
B. Molecular mimicry
C. Polyclonal B cell activation
D. Preferential activation of T helper cells
A
B. Molecular mimicry
51
Q
- “Superantigens” are toxins produced by
some strains of Staphylococcus aureus
and group A streptococci and cause
damage by
A. Molecular mimicry
B. Polyclonal T cell activation
C. Lysing white blood cells and platelets
D. Lysing red blood cells
A
B. Polyclonal T cell activation
52
Q
- The first serologic marker to appear in
patients with acute hepatitis B virus infection is
A. Anti-HB
B. Anti-HBc
C. Anti-HBe
D. HBsAg
A
D. HBsAg
53
Q
- A living donor is being sought for a child
who requires a kidney transplant. The best
odds of finding an MHC-compatible
donor occur between the child and
A. A sibling (brother or sister)
B. An unrelated individual
C. The child’s father
D. The child’s mother
A
A. A sibling (brother or sister)
54
Q
- Cells that can act as antigen-presenting
cells for exogenous antigens include
A. All nucleated cells
B. Endothelial cells
C. B lymphocytes
D. T lymphocytes
A
C. B lymphocytes
55
Q
- In patients with human immunodeficiency virus infection, immune status can be monitored by measuring the ratio of
A. CD3+ cells to CD8+ cells
B. CD4+ cells to CD8+ cells
C. Lymphocytes to monocytes
D. T cells to B cells
A
B. CD4+ cells to CD8+ cells
56
Q
- Why does vaccination against hepatitis B virus (HBV) also prevent hepatitis D virus (HDV) infections?
A. An immunogen from HBV in the vaccine is also associated with HDV.
B. The HBV vaccine induces formation
of heterophile antibodies that cross
react with HDV.
C. The HBV vaccine stimulates liver cells
to produce antiviral molecules active
against all hepatitis viruses.
D. HDV requires the host to be concurrently infected with HBV.
A
D. HDV requires the host to be concurrently infected with HBV.
57
Q
- B lymphocytes and T lymphocytes are
derived from
A. Hematopoietic stem cells
B. Macrophages or monocytes
C. Mucosa-associated lymphoid tissue
D. The fetal liver
A
A. Hematopoietic stem cells
58
Q
- Contact dermatitis is mediated by
A. B lymphocytes
B. T lymphocytes
C. Macrophages
D. Polymorphonuclear cells
A
B. T lymphocytes
59
Q
- In a competitive radioimnumosorbent test (RIST), what does a high signal suggest?
A. The patient sample has a low
concentration of IgE.
B. The patient sample has a low
concentration of IgM.
C. The patient sample has a high
concentration of IgE.
D. The patient sample has a high
concentration of total antibody.
A
A. The patient sample has a low
concentration of IgE.
60
Q
- An antibody titration is depicted in Color Plate 25 *. In this titration, a 0.2 mL aliquot of a patient’s serum sample was added to 0.8 mL of saline, and this mixture was placed into tube #1. A 0.5 mL sample was removed from tube #1 and placed into
tube #2, containing 0.5 mL of saline. This
procedure was repeated through tube #10.
The dilutions were assayed for antibody to
an infectious agent. How should the
antibody titer be reported?
A. 256
B. 512
C. 640
D. 1280
A
C. 640
61
Q
- In a chemiluminescent immunologic
assay, what is the signal detected?
A. Light
B. An electric signal
C. A purple-colored compound
D. A yellow-colored compound
A
A. Light
62
Q
A 28-year-old female complains to her family physician of abdominal pain, loss of appetite, and low-grade fever. Physical examination reveals abdominal tenderness
and a low-grade fever. Her physician
orders a hepatitis profile and obtains the
results below.
Anti-HAV Nonreactive
Anti-HBc Reactive
Anti-HBs Nonreactive
HBsAg Reactive
HBeAg Reactive
Anti-HCV Nonreactive
Which of the following is the most likely conclusion?
A. Acute HAV infection
B. Acute HBV infection
C. Chronic HBV infection
D. Immunity to HBV due to past
infection
A
C. Chronic HBV infection
63
Q
- An 11-year-old female presents with fever, sore throat, lethargy, and tender cervical lymphadenopathy. Relevant findings include splenomegaly and lymphocytosis, with many large reactive (atypical) lymphocytes. A heterophile antibody test was negative. Further laboratory results were as follows:
IgG and IgM
Cytomegalovirus (CMV) - 20 0
Epstein-Barr virus (EBV) VGA - 0 80
Mono spot - 0 0
What conclusion can be made concerning
the diagnosis?
A. Acute CMV infection
B. Acute EBV infection
C. Chronic CMV infection
D. Chronic EBV infection
A
B. Acute EBV infection
64
Q
- A male infant had been well until about 5 months of age, at which time he was
diagnosed as having otitis media and
bronchitis caused by Haemophilus
influenzae. Over the next several months he presented with streptococcal pneumonia several times. At 10 months of age a serum protein electrophoresis showed a virtual lack of gamma globulins. Quantitative serum levels were as follows: 75 mg/dL IgG and undetectable levels of IgM, IgA, and IgE. There were a normal number of T cells, and they exhibited normal mitogen stimulation. What disease does this child most likely suffer from?
A. Combined immunodeficiency
B. DiGeorge syndrome
C. latrogenic immunodeficiency
D. X-linked agammaglobulinemia
A
D. X-linked agammaglobulinemia
65
Q
- A 25-year-old male presents to his family physician complaining of fatigue, diarrhea, and weight loss of a few months duration. On physical examination the patient is found to have a fever and abdominal discomfort. Laboratory results indicate a white blood cell count of 14.3 X 109/L (reference range 4.8-10.8 X 109/L). Assays for HBSAg and anti-HCV are negative. An ELISA test for antibodies to the human immunodeficiency virus (HIV) performed on the patient’s serum is found to be reactive. What step should be taken next?
A. Call the physician with the HIV result.
B. Repeat the HIV ELISA test on the
sample.
C. Test the patient’s serum for anti-HBs.
D. Contact the patient to collect a second
sample.
A
B. Repeat the HIV ELISA test on the
sample.
66
Q
- A 38-year-old woman visited her
physician because of fatigue, fever, and
joint pain (proximal interphalangeal,
wrist, and knee joints). She also noticed
sensitivity to the sun and reported having a
rash following recent exposure. The
physician noted a rash over her nose and
cheeks. Laboratory results included white
blood cell count 5.5 X 109/L (reference
range 4.8-10.8 X 109/L) and red blood
cell count 4.5 X 1012/L (reference range
4.0-5.4 X 1012/L). Urinalysis results
were within reference ranges, except for
4+ protein and 1+ RBCs, 0-3 hyaline
casts/lpf and 0-1 RBC cast/lpf on
microscopic examination. Which of the
following tests would be most helpful in
diagnosing this patient’s condition?
A. Anti-nuclear antibody
B. a-Fetoprotein
C. Anti-streptolysin O
D. Hepatitis profile
A
A. Anti-nuclear antibody
