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MTAP 1 FINALS - EE > SEROLOGY CIULLA > Flashcards

SEROLOGY CIULLA Flashcards

1
Q
  1. 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

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2
Q
  1. 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

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3
Q
  1. 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.

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4
Q
  1. 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

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5
Q
  1. 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

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6
Q
  1. 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

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7
Q
  1. 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

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8
Q
  1. 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

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9
Q
  1. 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

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10
Q
  1. 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

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11
Q
  1. 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

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12
Q
  1. 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

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13
Q
  1. 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

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14
Q
  1. 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

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15
Q
  1. 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

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16
Q
  1. 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)

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17
Q
  1. 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

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18
Q
  1. 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

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19
Q
  1. 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

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20
Q
  1. Loss of self-tolerance results in
    A. Autoimmune disease
    B. Graft-versus-host disease
    C. Immunodeficiency
    D. Tumors
A

A. Autoimmune disease

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21
Q
  1. 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

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22
Q
  1. 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.

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23
Q
  1. 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.

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24
Q
  1. Monoclonal antibodies are produced by
    A. Cultured T cells
    B. Human plasma cells
    C. Mouse plasma cells
    D. Hybridomas
A

D. Hybridomas

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25
Q
  1. Antibodies that bind to the same epitope are of the same
    A. Allotype
    B. Autotype
    C. Idiotype
    D. Isotype
A

C. Idiotype

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26
Q
  1. 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.

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27
Q
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. Hashimoto disease is an autoimmune
    disease primarily involving the
    A. Kidneys
    B. Liver
    C. Lungs
    D. Thyroid gland
A

D. Thyroid gland

50
Q
  1. 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
  1. “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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. Contact dermatitis is mediated by
    A. B lymphocytes
    B. T lymphocytes
    C. Macrophages
    D. Polymorphonuclear cells
A

B. T lymphocytes

59
Q
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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

MTAP 1 FINALS - EE (3 decks)

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