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Immunology final
Immunology/serology final
| Question | Answer |
|---|---|
| Which class of immunoglobulins possesses 10 antigen sites? | IgM |
| Which class of immunoglobulins binds to basophils and mast cells to mediate immediate hypersensitivity reactions? | IgE |
| What is the predominant type of antibody found in the serum of neonates born after full term gestation? | Maternal IgG |
| HLA antigens are found on? | All nucleated cells |
| After exposure to antigen, the first antibodies that can be detected belong to the class: | IgM |
| Monoclonal antibodies are produced by? | Hybridomas |
| Which class of antibody, referred to as incomplete antibody, is able to agglutinate RBC's after anti-human globulin is added? | IgG |
| Which of the following immunoglobulins is most prevalent in secretions? | IgA |
| Which of the following factors are associated with declining levels of immunity? | Advanced age, Poor nutrition, Inability to cope, Alcoholism |
| Which of the following cells is associated with cell-mediated immunity? | T-Lymphocytes |
| Another name for antibody-mediated immunity is: | Humoral |
| Specific antigenic determinants of the antibody that processes a unique structure on the variable portion of light and heavy chains? | Idiotypic |
| Genetically different individuals are referred to as? | Allogenic |
| Which of the following characteristics is not true of an anamnestic response compared to a primary response? | IgM antibodies predominate |
| Which type of antibody is capable of placental transfer? | IgG |
| Which is true about monoclonal antibodies? | Engineered to bind to a single specific cell, purified antibodies, cloned from a single cell, used to classify and identify specific cellular membrane characteristics |
| The principal type of leukocyte in the process of phagocytosis is he: | Neutrophil |
| A primary function of the eosinophil is? | Suppression of the inflammatory response |
| The host defense functions of monocytes/macropages includes? | Secretion of biologically active molecules, antigen presentation, phagocytosis |
| Which statement about basophils is True | Are associated with anaphylactic shock, have high concentrations of heprin and histamine in granules |
| Defective mobilization | Diabetes |
| Defect in bactericidal ability of neutrophils | Myeloperoxidase deficiency |
| Failure to exhibit increased anaerobic metabolism during phagocytosis | Chronic granulomatous disease |
| Defect in cellular response to chemotaxis | Chediak-Higashi Anomaly |
| Which is the correct order of action regarding phagocytosis | Chemotaxis, adherence, engulfment, digestion |
| T cell lymphocytes gain maturity in the thymus orginating from bone marrow progenitor cells | true |
| Which of the following Are secondary lymphoid tissues? | GALT, Filtration & drainage system, thoracic duct |
| 8-cell differentiation | CD4 |
| Cytotoxic T cells | CD8 |
| Macrophage | APC |
| The term "pentameric" refers to an immunoglobulin molecule involved in secondary response | false |
| SCIDS refers to? | Severe combined immunodeficiency syndrome, a disease usually affecting babies, results in early death, and results in numerous infections |
| What is true regarding B lymphocytes | Humoral immune response, production of immunoglobulins, activation, secretion |
| Factors the influence the development of an infectious disease include all of the following: | Immune status of an individual, Pathogenicity of the agent, Incidence of an organism in the population |
| Varicella-zoster virus can be reactivated in all the following: | Aids, Elderly, Compromised |
| For an infectious disease to develop in a host, the organism must initially...: | Penetrate the skin or mucous membrane barrier |
| Why is phagocytosis Not an effective device for human immunity when the body is fending of f a parasite? | They are able to migrate away from the phagocyte |
| The best diagnostic protocol for determining the stage of infection the patient is in, involves: | Testing MULTIPLE specimens during the course of the disease |
| Rising titer during testing of paired specimens is an indication of | increasing severity of the disease |
| What type of B cells are formed after antigen stimulation? | Plasma cells and memory B cells |
| Which T cell expresses the CD8 marker and acts specifically to kill tumors or virally infected cells? | T cytotoxic |
| Which of the following antigens is classified as an MHC class II antigen? | HLA-DR |
| Soluble mediators of the immune system generally refers to the________ cascade proteins | Complement |
| Which of the following is the primary major protein involved in the complement cascade proteins? | C3 |
| The main function of C3 convertase is? | Cleavage of the C3 molecule resulting in C3b |
| The controlling event of the alternate complement pathway is? | Factor H prvention of association between C3b and factor B |
| The radioallergosorbent test (RAST): | Uses antigen specific IgE Antibody |
| The CH50 assay is useful for? | Following course of an immune complex disease, screening genetic deficiencies of te complement system, the diagnosis of hereditary angio-neurotic edema |
| Enzyme immunoassay (EIA) has replased radioimmunoassay (RIA) because RIA: | Creates a hazardous waste problem |
| In radial immunodiffusion (RID), specific_______ are added to the buffered agarose medium: | Antibodies |
| Radial immunodiffusion (RID) measures______ at the optimal point of diffusion. | Diameter or precipitation |
| DNA can be amplified by: | "in vitro" amplification and cloning |
| The advantages of molecular testing include: | Faster turn around time, smaller specimen volume, increased specificity |
| The clinical application of the analysis of amplification products includes: | Genetic testing, hematopathology diagnosis and monitoring, and Identification of infectious agents |
| Reverse transcriptase PCR applications include identification of : | HIV and HCV |
| Amplification of nucleic acid fragments from a different target is performed with : | Multiplex PCR |
| Steps in the enzymatic process of the PCR cycle: | DNA denaturation, Primer anneling, Extension of the primed DNA sequence |
| The important applications of PCR include all the following: | Amplification of DNA, detection of genetic mutations, synthesis of a labeled anti-sense probe |
| The first phase of aggultination and a representative of the physical attachment of antibody molecules to antigens on the RBC membrane refer to...: | Sensitization |
| Serum protein Elecetrophoresis separates proteins into: | Albumen and Globulin Fractions |
| All the following are true regarding PCR: | Amplifies low levels of DNA, Two short DNA primers are used, oligonucleotides act as a template |
| Current uses of cell cytometry use: | four monoclonal antibodies directly conjugated to a distinct fluorochrome |
| In nephelometry measurement, a______method is used: | Fixed time |
| A disadvantage of nephelometry is | lipemic must be rejected and a new specimen must be obtained |
| A fundamental prerequisite for nephelometric protein quantitation is: | Formation of a macromolecular complex |
| Which of the following is correct regrading measurement of turbidity? | Light is scattered at an angle that is determined |
| A nephelometric immunoassay is an example of a: | competitive immunoassay |
| Latex particles act as _____ in nephelometry? | Antigen-coated reaction intensifiers |
| An Antigen passively attached to red blood cells are bound by antibodies is called: | Indirect hemagglutination testing |
| The amount of antigen and antibody binding in latex aggultination procedures is influenced by | pH, ionic concentration of solvent, and Osmolarity |
| The force of attraction between an antibody and a single antigenic determinant is: | affinity |
| The chemical binds of importance in aggulation reactions are | Ionic bonds, hydrophobic binds, and hydrogen bonds |
| The "Lattice hypothesis" states that an optimal reaction occurs between antigen and antibody when: | Antigen and antibody are present in approximately equal proportions. |
| The strength of an aggulutination reaction can be enhanced by: | Centerfugation, the use of albumin, and the use of low-ionic-strength saline |
| A reaction between soluble antigen, soluble antibody and particulate antigen is the definition of? | Agglutination |
| Monoclonal IgE leads to | Short, thick arcs in the antigen well |
| Diagnosed as IEP, Single clone of plasma produces increased levels of single class and type of immunoglobulin(Ig) | Monoclonal gammopathy |
| Monoclonal gammopathies can be observed in: | a malignancy, Multiple myeloma, and macroglobulemia |
| The immunoelectrophoresius of a normal serum typically depicts IgM, IgG, and IgA bands, but IgD and IgE bands are missing because: | Normal concentrations of IgD and IgE are too low to be detected. |
| Monoclonal IgM bands are: | Skewed arcs of a circle |
| In IEP, When a favorable antigen ratio is reached, the antigen-antibody complex becomes visible as: | Bands, lines, and a line representing one specific protein |
| IEP is a reliable and accurate method for detecting | structural abnormalities and concentration changes in protein |
| Evaluation of abnormal precipitin band can include assessing? | Any deviation of position and shape of precipitin bands |
| Monoclonal IgA gammopathy has a distinctive immunoelectrophoresis (IEP) feature of: | Antibody position of band precipitin |
| To be used in the enzyme immunoassay (EIA), an enzyme must have | A high amount of stability and extreme specificity |
| The use of recombinant DNA technology, the detection of hematophathologic and oncogenic chromosomal abnormalities | FISH tecnology |
| Automated DNA sequences, DNA probe technology and gel electrophoresis are used by: | Magnetic labeling application |
| The enzyme immunoassay (EIA) method can be used for analysis of: | Anti-IgM Anti-HBc, IgM and IgG of Borrelia burgdorferi, and cytomegalovirus (CMV) IgG and IgM antibodies |
| Indirect immunofluorescent assay (IFA) is widely used for detection of | Autoantibodies, antibody to tissue antigen, and antibody to cellular antigen |
| An advantage of enzyme immunoassay (EIA) compared to radioimmunoassay (RIA) is: | No radioactive hazardous waste |
| Which of the following is an undesirable characteristic of antibodies used in enzyme immunoassay | High cross-reactivity |
| In competitive immunoassay, the amount of light emmitted for measurement____as the concentration of the analyte being measured_____? | decreases, increases |
| The complement component found in the all of the pathways is | C3 |
| Which of the following characteristics is representative of C-reactive protein | The first acute phase reactant to become elevated, nonspecific indicators of inflammation, C-RP is an acute phase reactant |
| The measurement of C-reactive Protein can NOT be used for: | Diagnosis of viral septicemia |
| The classic complement pathway is activated by | Recognition by complement factor C1 of antigen-antibody complexes on the cell surface |
| The alternate complement pathway is activated by: | Components of the bacterial cell surface in the absence of antigen-antibody |
| Factor H acts by competing with _______for the same binding site in complement reactivity | Factor B |
| Factors that influence the development of an infectious disease include: | Immune status of the individual, Incidence of an organism int he population, and the pathogenesis of the agent. |
| The detection of _____ can be diagnostic significance during the first exposure of a patient to an infectious agent. | IgM |
| A distinguishing characteristic of the herpes viruses is that they are | cell associated and humans are the only known reservoir of infection |
| Strp pyogenes is the most common causative agent of all the following disorders and complications | Pharyngitis, scarlet fever, and impetigo |
| Long term complications pf S pyogens infection can include | Acute rheumatic fever and Rheumatoid Arthritis |
| A CLT is writing the SOP for VDRL. Under which section would they include info regarding checking the number of drops from the needle used to dispense the antigen reagent? | Quality control |
| Dark field microscopy may be performed during which stage of syphilis? | Primary is organism is present |
| What does TORCH stand for: | Toxoplasmosis, other lab tests, Rubella, CMV, Herpes |
| The following is true regarding S. agalactiae | Is usually isolated in the blood, is responsible for increased mortality especially in neonates, and Pts w/ underlying complications are particularly susceptible |
| Congenital syphilis may involve which of the following as the child develops? | Nerve deafness, Hutchinson's teeth, Hutchinsonian triad |
| Increased presence of a false negative in a test method involves decreased level of...: | sensitivity |
| Inactivation of complement for the FTA procedure involves heat treatment at ____degrees C for _____minutes. | 56 degrees for 30 minutes |
| The term "double dilutions" refers to: | Two-fold increase in dilution from tube to tube |
| HLA antigens are found on | All nucleated cells |
| Toxoplasma- infected mothers who are not treated can give birth to a (n): | congenitally infected infant |
| The type of immunity that follows the injection of antibodies synthesized by another individual or animal is termed | passive |
| Monoclonal antibodies are produced by | hybridomas |
| Which of the following infectious diseases is usually diagnosed by an antigen detection test rather then an antibody detection test? | Cryptococcosis |
| The ability of a virus to invade a human body is dependent MOST on | Cellular replication |
| What disease is associated with Varicella Zoster virus | Shingles |
| The presence of the "M protein" is a major virulence factor for which organism? | GAS (group A strep) |
| Which of the following applies to Hepatitis D | Requires the presence of Hep B, May involve co-infections and super infections |
| Lyme disease is caused by a _____ | Spirochete |
| What type of B cells are formed after antigen stimulation | Memory cells and Plasma cells |
| The detection of precipitation reaction depends on the presence of maximal proportions of antigen and antibody. A pt's sample contains a large amount of antibody, but the reaction in a test system containing antigen is negative. What has happened? | Prozone phenomenon |
| What comprises the indicator system in an ELISA for detecting antibody? | Enzyme-conjugated antibody+ chromogenic substrate |
| What is the titer in tube number 8 if tube number 1 is undiluted and dilutions are doubled | 128 |
| What substance is detected by the rapid plasma reagin (RPR) and venereal disease research Laboratory (VDRL) tests for syphilis? | Reagin |
| What type of antigen is used in the RPR card test? | Cardiolipin |
| A 12 year old girl has symptoms of fatigue and a localized lymphadenopathy. Lab test reveal a peripheral blood lymphocytosis with a atypical (reactive) lymphocytes, and a positive spot test for IM. What test should be performed next? | EBV specific antigen test |
| Which test is most likely to be positive in the tertiary stage of syphilis? | FTA-ABS |
| Which specimen is the sample of choice to evaluate latent or tertiary syphilis? | CSF |
| What is the most likely explanatin when antibody tests for HIV are negative but a NAT test for HIV is positive? | Patient is in "WINDOW" phase before antibody production |
| Which hep B marker is the best indicator of early acute infection? | HBsAg |
| If only anti-HBs is positive, which of the following can be ruled out? | Chronic hep B virus infection |
| In monitoring an HIV- infected patient, which parameter may be expected to be the most SENSITIVE indicator of the effectiveness of antiretroviral treatment? | HIV viral load |
| The risk of fetal anomalies in maternal rubella is highest at the : | first month |
| Which of the fololowing is a symptom of an inflammatory condition? | Pain, redness, burning, and swelling |
| Which of the following are enzyme markers useful in identifying HEP diseases? | AST,ALT,ALP,LD |
| Type I hypersensitivity reactions are characterized by: | Activattion of complement and Antigen cross-links with IgE on mast cells |
| Cell-mediated immunity is responsible for: | Contact sensitivity, Elimination of tumor cells bearing neoantigens, and the Rejection of foreign tissue graft. |
| Cell mediated | Delayed hyper sensitivity |
| Antibody mediated | Immediate hyper sensitivity |
| Dependent on the host response to a subsequent exposure of antigen | Immunization, or sensitization |
| Not mediated by antigen-antibody interaction | Anaphylactoid reaction |
| The major growth factor for multiple myeloma cells is: | IL-6. |
| Which laboratory assay has been adopted as a prognostic indicator in multiple myeloma? | β2-microglobulin |
| Patients with multiple myeloma (MM) have defects in _____ but not in _____. | humoral immunity; cellular immunity |
| The most consistent immunologic feature of multiple myeloma (MM) is: | A. Incessant synthesis of a dysfunctional single monoclonal protein. B. Incessant synthesis of immunoglobulin chains of fragments. C. Suppression of the synthesis of normal functional antibody. |
| What is the M component in a monoclonal gammopathy? | Monoclonal antibody or cell line |
| The diagnosis of multiple myeloma (MM) depends on: | Greater than10% plasma cells in the bone marrow. |
| Fill in the blanks, choosing the correct temperature.Bence Jones (BJ) proteins are soluble at room temperature, become insoluble near (1) _______, and then resolubilize at (2) ________. | 60° C and 80° C |
| Benign or malignant condition that results from a single clone of lymphoid-plasma cells producing elevated levels of a single class and type of immunoglobulin | Monoclonal gammopathy |
| Condition characterized by the elevation of two or more immunoglobulins by several clones of plasma cells | Polyclonal gammopathy |
| Decreased tolerance to “self” antigens. | autoimmunity |
| Which of the following disorders is considered to be "organ nonspecific"? | Systemic lupus erythematosus |
| An individual may develop an autoimmune response to: | Antigens that do not normally circulate in the blood, Altered antigens, Loss of immunoregulatory function by lymphocyte subsets. |
| The basic immunologic mechanism responsible for autoimmune disorders is related to: | Deposition of circulating immune complexes. |
| Anti-DNA antibody is associated with: | Systemic lupus erythematosus (SLE). |
| The etiology of insulin-dependent diabetes mellitus is: | Immune destruction of B lymphocytes in pancreatic islets. |
| Pernicious anemia is characterized by: | Deficiency of vitamin B12, Presence of antiparietal antibodies, Presence of IF-blocking antibodies. |
| Most immunologically mediated renal diseases fall into one of the following categories except: | Association with circulating antigen. |
| Measures antibody to nuclear antigens | ANA |
| Produces a characteristic granular cytoplasmic staining pattern to cytoplasmic constituents of granulocytes | Antineutrophil antibody |
| An antibody to a basic nonhistone nuclear protein | Anti-Scl antibody |
| Found in about 80% of patients with pernicious anemia | Anti parietal cell antibody |
| A condition called the _____________ syndrome can be secondary to lupus and may complicate pregnancy. | antiphospholipid |
| SLE is more common in: | Adult women. |
| Laboratory features of SLE include: | The presence of ANAs, Circulating anticoagulant and immune complexes, Decreased levels of complement. |
| A major cellular immunologic feature of SLE is: | Lack of generalized suppressor T-cell function, Reduction of generalized suppressor T-cell function, Hyperproduction of helper T cells. |
| What autoimmune disorder is indicated by an increased titer of anti-Sm (anti-Smith) antibody? | Systemic lupus erythematosus |
| The site of deposition of immune complexes in systemic lupus erythematosus (SLE) is determined by: | Molecular configuration, Immunoglobulin class, Complement-fixing ability. |
| Many of the clinical manifestations of systemic lupus erythematosus are a consequence of: | Tissue damage mediated by immune complexes. |
| Can affect the skin, joints, and almost any organ or body system, including the lungs, kidneys, heart, and brain | Systemic |
| Always limited to the skin | Discoid |
| Can be caused by procainamide | Drug induced |
| Immunologic features of rheumatoid arthritis include anti–cyclic citrullinated peptide. | true |
| Immunologic features of rheumatoid arthritis include immune complexes. | True |
| Immunologic features of rheumatoid arthritis include antinuclear antibodies. | True |
| Pathogenic mechanisms hypothesized for rheumatoid arthritis (RA) include: | A. An infective agent or other stimulus that binds to receptors on dendritic cells (DCs) and Activated T lymphocytes that proliferate and migrate into the joint. |
| A biologic false-positive rheumatoid factor (RF) assay can be manifested by patients with: | Systemic lupus erythematosus (SLE), Hepatitis, Syphilis. |
| Class II transplant antigens are expressed on: | B lymphocytes, Activated T lymphocytes, and Macrophages. |
| Which of the following antigens is a MHC class II antigen? | HLA-DQ and HLA-DR |
| Which of the following class of MHC antigens is necessary for antigen recognition by CD4+ T lymphocytes? | Class II |
| The major histocompatibility complex (MHC) D region codes for _____ molecules. | Class II |
| The most efficient method of preventing graft-versus-host disease (GVHD) is: | Irradiating the blood components pretransfusion. |
| Graft between individuals of different species (e.g., pig heart valve to a human heart) | Xenograft |
| Graft transferred from one position to another in the same individual (e.g., skin, hair, bone) | Autograft |
| Graft between genetically different recipient and donor of the same species; the grafted donor tissue or organ contains antigens not present in the recipient | Allograft |
| Graft transplanted between different but identical recipient and donor (e.g., kidney transplant between monozygous twins) | Syngraft |
| They are pluripotent, They are found in bone marrow and peripheral circulating blood, and They contain precursor cells to leukocytes and platelets. | progenitor blood cells |
| Hematopoietic stem cells are: | CD34+ cells. |
| Stem cell selection can be improved using the CD_______ cell surface marker. | 34+ |
| Pretransplant evaluation of a bone marrow recipient includes: | HLA tissue typing, Disease status, and Compatibility of donor and recipient. |
| Complications of bone marrow or peripheral blood stem cell (PBSC) transplantation include: | Infection and graft-versus-host disease (GVHD), Acute rejection and organ damage, and Chronic rejection and death. |
| A major complication in patients with bone marrow (BM) or peripheral blood stem cell (PBSC) transplant during the first month after transplantation is: | Graft-versus-host disease (GVHD). |
| Stem cells from identical twins | Syngeneic |
| Marrow from a related or unrelated donor | Allogeneic |
| Transplant of own cells | Autologous |
| Tumors are neoplasms. | TRUE |
| Tumors can be described as benign or malignant. | TRUE |
| Cell surface molecules coded for by tumorigenic viruses | Tumor-associated antigens |
| Gene derepression is responsible for the production of increased concentrations of these gene products | Carcinofetal antigens |
| Chemically induced tumors | Tumor-specific antigens |
| Caused by no known mechanism | Spontaneous tumor antigens |
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