1105 Exam 4 (Bishop: 7, 8, 9, + 10/CLS: 8 + 9, Molecular: 3, 4, 5, 6, + 12)
In nephelometry, the antigen-antibody complex formation is enhanced in the presence of a. Polyethylene glycol b. High ionic strength saline solution c. Normal saline d. Complement
a. Polyethylene glycol
Which of the following steps in automation generally remains a manual process in most laboratories? a. Preparation of the sample b. Specimen measurement and delivery c. Reagent delivery d. Chemical reaction phase
a. Preparation of the sample
The nucleic acid technique in which RNA is converted to cDNA, which is then amplified, is known as a. RT-PCR b. PCR c. RFLP d. In situ hybridization
a. RT-PCR
Which unlabeled immune precipitation method in gel is used to quantitate a serum protein? a. Radial immunodiffusion b. Double diffusion c. Counterimmunoelectrophoresis d. Immunofixation electrophoresis
a. Radial immunodiffusion
Which of the following specimens is NOT used for a waived POC test? a. Urine b. Whole blood c. Plasma d. Eye fluid
c. Plasma
Bidirectional communication between the chemistry analyzer and the laboratory information system has had the greatest impact on which of the following phases of clinical testing? a. Preanalytical b. Analytical c. Postanalytical d. All of the above e. None of the above
c. Postanalytical
The polymerase chain reaction (PCR) involves 3 processes. What is the correct order of these processes?
1. denaturation 2. annealing 3. extension
What is the composition of the primer used in PCR?
An oligonucleotide complimentary to bases at the beginning of the target
A low-molecular-weight molecule that is unable to induce an immune response unless it is linked to carrier protein is a(n):
Hapten
The protein molecule formed when a foreign material is introduced into an immunocompetent individual is a(n):
Antibody
The earliest automated analyzers were of the _________________ design.
Continuous flow
True or False? Computer interfaces are important to the laboratory for accuracy of analytical testing is improved.
False
True or False? Molecular arrays typically contain a single probe for high-throughput analysis of gene expression or determination of mutation in patient samples.
False
True or False? Molecular arrays typically contain a single probe for high-throughput analysis of gene expression or determination of mutations in patient samples.
False
The immunoassay that is based on the ability of an antibody to modulate the amount of light emitted from a fluorophore-ligand complex is:
Fluorescence Polarization Immunoassay (FPIA)
The immunoassay that is based on the ability of an antibody to modulate the amount of light emitted from a fluorophore-ligand complex is:
Fluorescence polarization immunoassay (FPIA)
Current automated analyzers are able to assess:
Interference
The development of "real-time" PCR was driven by:
Learning that Taq polymerase has 5' to 3' exonuclease activity
The ability of immune complexes to be captured and then detected on the surface of a glass fiber matrix is the basis for what immunoassays?
Microparticle enzyme immunoassay (MEIA)
What immunoassays produces a fluorescent molecule, 4-methylumbelliferone that serves as the detector compound?
Microparticulate enzyme immunoassay
The double diffusion or Ouchterlony technique is an example of which immune precipitation method?
Passive
In nephelometry, the antigen-antibody complex formation is enhanced in the presence of:
Polyethylene glycol
An immunoassay based on the direct observation of antigen-antibody reaction within a gel matrix is:
Radial immunodiffusion
Plastic beads, polyclonal gels, and particles coated with iron oxide used in immunoassays are all examples of what type of material?
Solid phase material
What hybridization technique is used to detect DNA containing a specific base sequence by applying a labeled probe to DNA bands immobilized onto nitrocellulose paper following electrophoresis?
Southern blot
T/F: Washing the transfer membrane (e.g., nitrocellulose or nylon) at high temperature is considered a "high stringency" condition for DNA probe protocols.
True
True or False? Automating laboratory testing has resulted in a reduction in the number of laboratory errors.
True
Over-the-counter test kits are in which CLIA category?
Waived
Monoclonal antibodies are derived from:
a single plasma cell
The first commercial centrifugal analyzer was introduced in what year? a. 1970 b. 1957 c. 1967 d. 1976
a. 1970
Which of the following statements correctly describes competitive immunoassay? a. A fixed amount of labeled antigen competes with unlabeled antigen from a patient specimen for a limited number of antibody-binding sites. b. The sample antigen binds to an antibody; a second antibody labeled with a chemiluminescent label, binds to the antigen-antibody complex. c. Excess reagent; linear binding to one site. d. Capture antibody actively absorbed; antigen from specimen allowed to react.
a. A fixed amount of labeled antigen competes with unlabeled antigen from a patient specimen for a limited number of antibody-binding sites.
A test menu is: a. A listing of all of the tests or analytes that the instrument is capable of measuring. b. A listing of all the reagents on-board the analyzer. c. A listing of preventative maintenance tasks that needs to be performed. d. A listing of consumables used by the analyzer.
a. A listing of all of the tests or analytes that the instrument is capable of measuring.
All of the following are advantages to automation EXCEPT a. Correction for deficiencies inherent in methodologies b. Increased number of tests performed c. Minimized labor component d. Use of small amounts of samples and reagents in comparison to manual procedures
a. Correction for deficiencies inherent in methodologies
When sequencing DNA, ______ stops DNA synthesis in polymerase chain reaction amplification. a. Dideoxynucleotides b. DNA polymerase c. Insertion of thymine d. 3′-OH group e. Pyrophosphates
a. Dideoxynucleotides
Which of the following approaches to analyzer automation can use mixing paddles to stir? a. Discrete analysis b. Centrifugal analysis c. Continuous flow d. Dry chemistry slide analysis
a. Discrete analysis
Which of the following types of analyzers offers random access capabilities? a. Discrete analyzers b. Continuous flow analyzers c. Centrifugal analyzers d. None of these
a. Discrete analyzers
Which homogeneous immunoassay relies on inhibiting the activity of the enzyme label when bound to antibody reagent to eliminate separating free labeled from bound labeled reagent? a. EMIT b. CEDIA c. MEIA d. ELISA
a. EMIT
EQC per CLIA means a. Equivalent b. Electronic c. External d. Essential
a. Equivalent
The strength of binding between an antigen and antibody is related to the a. Goodness of fit between the epitope and the F(ab) b. Concentration of antigen and antibody c. Source of antibody production, because monoclonal antibodies bind better d. Specificity of the antibody
a. Goodness of fit between the epitope and the F(ab)
In flow cytometry, the side scatter is related to the a. Granularity of the cell b. DNA content of the cell c. Size of the cell d. Number of cells in G0 and G1
a. Granularity of the cell
All of the following are primary considerations in the selection of an automated chemistry analyzer EXCEPT a. How reagents are added or mixed b. The cost of consumables c. Total instrument cost d. The labor component
a. How reagents are added or mixed
Which of the following is NOT a driving force for more automation? a. Increased use of chemistry panels b. High-volume testing c. Fast turnaround time d. Expectation of high-quality, accurate results
a. Increased use of chemistry panels
Indirect immunofluorescence assay: a. Is based on the fact that antibodies can act as antigens and react with antiimmunoglobulins. b. Uses conjugated antibody to detect antigens-antibody reactions at a microscopic level. c. Has antigen first exposed to unlabeled antibody, then labeled antibody d. Is rarely used to detect diverse antibodies
a. Is based on the fact that antibodies can act as antigens and react with antiimmunoglobulins.
The development of "real-time" PCR was driven by: a. Learning that Taq polymerase that has 5′- to 3′ exonuclease activity b. The development of a dot blot hybridization methods c. The development of chain ligase reaction d. The ability to volatilize a sample in a nebulizer e. The development of scorpion primers
a. Learning that Taq polymerase that has 5′- to 3′ exonuclease activity
A CLIA waived test requires that operators a. Must follow manufacturer's instructions b. Must have annual competence assessment c. Must perform proficiency testing d. Must perform QC daily
a. Must follow manufacturer's instructions
For the PCR reaction to take place, one must provide which of the following? a. Oligonucleotide primers b. Individual deoxynucleotides c. Thermostable DNA polymerase d. All of the above
a. Oligonucleotide primers
One of the most common clinical applications for identifying SNPs in patients is: a. SNPs have been useful in optimizing the treatment of HIV. b. SNPs have been useful in diagnosing metabolic syndrome. c. SNPs have been used to facilitate transcription-mediated amplification. d. Currently, there are no clinical applications for the identification of SNPs as these are silent and have no apparent function. e. SNPs are added to the patient sample during polymerase amplification reactions to create the complimentary nucleic acid sequence.
a. SNPs have been useful in optimizing the treatment of HIV.
Of the following, which is a common example of solid support hybridization? a. Southern blot b. Chemiluminescence c. Hybridization protection assay d. Digene Hybrid Capture 2 e. In situ hybridization
a. Southern blot
You analyze the DNA content on a sample of breast tissue for suspected malignancy using flow cytometry and get the following results: DI = 2.5 and % cells in S phase = 29%. Based on these results you can conclude a. These results are likely indicative of a malignant breast tumor b. This is normal breast tissue c. These results are consistent with a mostly diploid population d. The results are not consistent with one another; no information is gained
a. These results are likely indicative of a malignant breast tumor
Dwell time refers to the a. Time between initiation of a test and the completion of the analysis b. Number of tests an instrument can handle in a specified time c. Ability of an instrument to perform a defined workload in a specified time d. None of these
a. Time between initiation of a test and the completion of the analysis
Enzyme immunoassay (EIA): a. Uses a nonisotopic label b. Uses antibody labeled with fluorescein isothiocyanate (FITC) c. Uses a colloidal particle consisting of a metal or an insoluble metal compound d. is not a safe technique
a. Uses a nonisotopic label
Which of the following chemistry analyzers uses slides to contain the entire reagent system? a. VITROS analyzers b. ACA analyzers c. Synchron analyzers d. None of these
a. VITROS analyzers
POCT assays are usually in which CLIA category? a. Waived b. Provider-performed microscopy c. Moderately complex d. Highly complex
a. Waived
The enzyme reverse transcriptase converts: a. mRNA to cDNA b. tRNA to DNTP c. dsDNA to ssDNA d. mitochondrial to nuclear DNA
a. mRNA to cDNA
A fluorescent substance is one that while _______ light of one wavelength, _______ light of another (longer) wavelength.
absorbing, emits
Any specimen, by a command to the processing systems, can be analyzed by any available process, in or out of sequence with other specimens, and without regard to their initial order describes which type of sample processing principle? a. Continuous flow analysis b. Random access analysis c. Batch and discrete analysis d. Centrifugal analysis
b. Random access analysis
In immunofixation electrophoresis, discrete bands appear at the same electrophoretic location, one reacted with antihuman IgA (α-chain-specific) reagent, and the other reacted with antihuman λ reagent. This is best described as a. An IgA λ monoclonal protein b. An IgA λ polyclonal protein c. IgA biclonal proteins d. Cross-reactivity
b. An IgA λ polyclonal protein
A glucose result is falsely elevated and it was discovered that the previous sample on the sample carousel has abnormally high serum glucose. Which of the following can cause this error? a. Pipetting an extra volume of diluents into the sample with the falsely elevated glucose b. Carryover c. A leak in the reagent-dispensing probe d. Double pipetting of the sample with the elevated glucose result
b. Carryover
An example of a modular integrated chemistry/immunoassay analyzer would be the a. Aeroset b. Dimension Vista 3000 T c. Paramax d. VITROS
b. Dimension Vista 3000 T
Which enzyme label is often used in immunoassay procedures? a. Acid phosphate b. Horseradish peroxidase c. Beta-Galactose d. All the above
b. Horseradish peroxidase
In monoclonal antibody production, the specificity of the antibody is determined by the a. Sensitized B lymphocytes b. Myeloma cell line c. Sensitized T lymphocytes d. Selective growth medium
b. Myeloma cell line
Quality control lockout a. Prevents quality control from being recorded when outside 2 standard deviations b. Prevents testing when quality control has not been performed c. Prevents operators from changing quality control records d. Prevents the wrong quality control material to be used for a particular test
b. Prevents testing when quality control has not been performed
Reflectance spectrometry uses which of the following? a. Luminometer b. Tungsten-halogen lamp c. Photomultiplier tube d. UV lamp e. Thermometer to monitor temperature in reaction vessel
b. Tungsten-halogen lamp
Immunofluorescence technique: a. Uses a nonisotopic label b. Uses antibody labeled with fluorescein isothiocyanate (FITC) c. Uses a colloidal particle consisting of a metal or an insoluble metal compound d. is not very sensitive or specific
b. Uses antibody labeled with fluorescein isothiocyanate (FITC)
Direct immunofluorescence assay: a. Is based on the fact that antibodies can act as antigens and react with antiimmunoglobulins. b. Uses conjugated antibody to detect antigens-antibody reactions at a microscopic level. c. Has antigen first exposed to unlabeled antibody, then labeled antibody d. Is not used for tissue sections or smears for microbiology
b. Uses conjugated antibody to detect antigens-antibody reactions at a microscopic level.
When using EMIT, the enzyme is coupled to: a. antibody b. antigen c. substrate d. coenzyme
b. antigen
Which of the following is an application of Western blot immunoassay? a.Messenger RNA is studied. b.Called immunoblot, it is used to detect antibodies to subspecies of antigens. c.Single-stranded DNA is studied. d.It involves isolating mRNA
b. called immunoblot, it is used to detect antibodies to subspecies of antigens
Modifications in microsampling and reagent dispensing improve which of the following phases in clinical testing? a. Physician ordering phase b. Preanalytical phase c. Analytical phase d. Postanalytical phase e. All of the above phases
c. Analytical phase
Increase test throughput, reduce turnaround time, and compensate for staff shortages are all examples of which of the following? a. Factors that drive manual procedures b. Management options used to reduce the number of technologist in the laboratory c. Factors that drive automation d. Factors that lead to more errors
c. Factors that drive automation
Inhibition immunofluorescence assay: a. Is based on the fact that antibodies can act as antigens and react with antiimmunoglobulins. b. Uses conjugated antibody to detect antigens-antibody reactions at a microscopic level. c. Has antigen first exposed to unlabeled antibody, then labeled antibody d. Is based on the fact that if unlabeled and labeled antibodies are homologous to antigen, fluorescence is produced.
c. Has antigen first exposed to unlabeled antibody, then labeled antibody
For laboratories with a provider-performed microscopy procedure CLIA certificate, which of the following would NOT be approved? a. Urinalysis b. Semen analysis c. Hematology differential d. Wet prep
c. Hematology differential
As the concentration of analyte begins to exceed the amount of antibody present, the dose response curve will flatten (plateau) and with further increase may become negatively sloped; this describes which of the following? a. Loss of sensitivity b. Logarithmic relationship of antibody concentration and millivolt output from the detector c. Hook effect d. Increase in precision
c. Hook effect
Which of the following statements best describes discrete testing? a. Automatically measures up to 10 different analytes on a serum specimen whether they are requested or not b. Measures analytes in serum samples only c. Measures only the test requested on a sample d. Automatically measures all of the tests that the analyzer is capable of performing
c. Measures only the test requested on a sample
Molecular typing of bacterial strains is based on restriction fragment length polymorphisms (RFLPs) produced by digesting bacterial chromosomal DNA with restriction endonucleases. Which of the following techniques is used to separate the large DNA fragments generated? a. Ribotyping b. DNA sequencing c. Pulsed field gel electrophoresis d. Reverse transcription-polymerase chain reaction
c. Pulsed field gel electrophoresis
Which of the following statements correctly describes competitive immunoassay? a. Excess binding sites for the analyte are provided. b. Labeled and unlabeled analyte are present in equal amounts. c. The concentration of patient analyte is inversely proportional to bound radioactive label. d. All the patient analyte is bound in the reaction.
c. The concentration of patient analyte is inversely proportional to bound radioactive label.
PCR testing is useful for: a. Forensic testing b. Genetic testing c. Identification of the disease d. All of the above
d. All of the above
Which of the following statements correctly describes sandwich immunoassay? a. A fixed amount of labeled antigen competes with unlabeled antigen from a patient specimen for a limited number of antibody-binding sites. b. The sample antigen binds to an antibody; a second antibody labeled with a chemiluminescent label, binds to the antigen-antibody complex. c. It is a type of noncompetitive assay. d. Both b and c.
d. Both b and c.
Which unlabeled immune precipitation method in gel is used to quantitate a serum protein? a. Counterimmunoelectrophoresis b. Double diffusion c. Immunofixation electrophoresis d. Radial immunodiffusion
d. Radial immunodiffusion
Competency for nonwaived testing a. Is required for the CLIA director b. Is NOT required for physicians in their specialty c. Should be performed and documented annually for all operators d. Should be performed and documented initially after 6 months, then annually thereafter
d. Should be performed and documented initially after 6 months, then annually thereafter
Which of the following represents a disadvantage to acquiring and implementing total laboratory automation? a. Increases labeling errors b. Increases turnaround times c. Increases the need for additional full time equivalents (FTEs) d. The initial costs are very high
d. The initial costs are very high
Connectivity for POCT provides the ability to a. Charge meters at docking stations on the hospital units b. Accept barcode patient identification c. Perform electronic quality control d. Transmit patient results to the medical record e. Prevent password sharing for operator identification
d. Transmit patient results to the medical record
TSA is of value in detecting: a. light chain mRNA molecules b. interferon gamma c. interleukin-4 d. all of the above
d. all of the above
The major benefit(s) of laboratory automation is (are): a. reduction in medical errors. b. improved safety. c. faster turnaround time. d. all of the above.
d. all of the above
Which of the following is considered a demand placed on the laboratory that serves to drive automation? a. Reduced turn around time b. Increased throughput c. Compensates for staff shortages in the laboratory d. all of the above
d. all of the above
Which of the following is a characteristic of fluorescence in situ hybridization (FISH)? a. semiconductor nanocrystals b. method of tagging antibodies with superparamagnetic particles c. technology based on two different 200nm latex particles d. molecular cytogenetic technique
d. molecular cytogenetic technique
What is studied in a Western Blot immunoassay?
detects antibodies to subspecies of antigens
What does hybridization do?
detects specific pieces of DNA
Separation of each sample and reagents into a separate container describes:
discrete analyzer
All of the following describe a nucleic acid probe except: a. Short strand of DNA of a known sequence b. Short strand of RNA of a known sequence c. Can be cloned in bacteria d. Can be inserted into a plasmid vector e. Can be labeled with avidin
e. Can be labeled with avidin
Which of the following is LEAST likely to affect the purification of genomic DNA for analysis in molecular methods? a. Sample volume required for hybridization b. Size of the nucleic acid to be isolated c. Presence of RNA in the sample d. Presence of protein in the sample e. Presence of deoxyribose
e. Presence of deoxyribose
Why is it important to add RNase to the patient sample when isolating genomic DNA? a. RNase serves as an enzymatic tag on DNA probes. b. RNase will remove excess collagen from the patient sample. c. RNase will transport the amino acid to the ribosome, where the peptide chain elongates. d. RNase clones DNA to RNA. e. RNase digests RNA in the patient sample that could copurify with genomic DNA.
e. RNase digests RNA in the patient sample that could copurify with genomic DNA.
An antigenic determinant on an antibody is the:
epitope
In the PCR method, how is denaturation accomplished?
heat
Which statement accurately describes the process of fluorescent in situ hybridization (FISH)?
hybridization is performed directly on intact chromosomes
What is studied in a Northern Blot immunoassay?
messenger RNA
Quality control lockout of a POCT device:
prevents testing when QC has not been performed.
The technique that makes ssDNA from an RNA template is called:
reverse transcriptase
What is studied in a Southern Blot immunoassay?
single-stranded DNA
An advantage of an open reagent system on an automated chemistry analyzer is:
the ability to use reagents produced by more than one supplier can provide a laboratory with the ability to customize testing, and possible, save money
Immunoassays depend on:
the binding of antigen and antibody.
