Immunology: Serologic and Molecular Procedures

All of the following are applications of real-time PCR EXCEPT

Amplification of DNA for northern blot

The enzymatic process in each PCR cycle consists of the following steps EXCEPT:

Analysis of PCR product

A physicians suspects his patient might have rheumatoid arthritis. Which of the following markers should be ordered?

Anti IgG

Which of the following is used to determine if a person has had a recent infection with Strep pyogenes?

Antistreptolysin O (ASO)

Which of the following autoantibodies would be usually found in a patient with Hashimoto's thyroiditis?

Antithyroid peroxidase (TPO)

Which of the following organisms is best visualized by use of a darkfield microscope

Borrelia

Which laboratory assay is a highly specific indicator and the most sensitive assay for a diagnosis of rheumatoid arthritis?

Cyclic citrullinated peptide

The most highly specific indicator for rheumatoid arthritis is:

Cyclic citrullinated peptide antibodies (CCP antibodies)

VDRL and RPR are examples of which of the following types of test methodologies?

Flocculation

What anti-Nuclear Antibody (ANA) straing pattern is prescented in the microscopic image?

Homogenous

Identify the ANA staining pattern in the image and interpret what related disorder can be associated with this pattern?

Homogenous or Diffused staining pattern; SLE

All of the following are advantages of HEp-2 and HEp-2000 over rodent tissue as cell substrates for ANA testing, EXCEPT? Human cell lines are more sensitive than rodent Human cell lines do not express Ro (SS-A) antigen Human cell lines express relevant nuclear antigens in the human tumor cell Nucleolar reactivity is detectable in human cell lines

Human cell lines do not express Ro (SS-A) antigen

All of the following are true about hybridization in PCR procedures, Except?

Hybridization cannot happen between a strand of DNA and a strand of RNA

Rocky Mountain Spotted fever (RMSF), caused by Rickettsia rickettsia, is MOST reliably diagnosed by which laboratory technique?

IFA testing

Examples of cytokines originating from activated T-cells include:

Il-2, Il-3

A cause of FALSE-POSITIVE result in the rapid plasma regain (RPR) test for syphilis is:

Infectious mononucleosis

The classic TORCH panel of tests includes the following diseases with the exception of:

Infectious mononucleosis

A major macrophage-activating cytokine is:

Interferon gamma

All of the following is true about realtime-PCR, EXCEPT?

It does not require the use of reverse transcriptase

When evaluating the patterns of fluorescent anti-nuclear antibody (FANA) testing, cytoplasmic patterns:

May demonstrate anti-mitochondrial antibodies seen primary biliary cirrhosis

What is the purpose of the Total Complement Activity (CH50) assay?

Measures classic or terminal complement pathways

Which of the following best describes the benefits of the RPR or VDRL test:

Monitoring the course of treatment

Which test is NOT used as a screen for retroviruses in donated blood?

Nucleic acid testing for HCV

ANA test is viewed using fluorescent microscopy, which pattern is this?

Nucleolar

A patient has a history of repeated spontaneous abortion. Coagulation studies reveal an elevated APTT, normal PT, normal platelet function, and normal thrombin time. Schistocytes were seen on the peripheral blood smear. Which test should be performed to determine if the patient has lupus anticoagulant?

Platelet neutralization test

A false positive result can be observed in a rheumatoid factor latex agglutination procedure reaction due to:

Poor specimen quality

An indirect latex agglutination assay was used to test for C-reactive protein in a patient sample. The results of the serial dilution are provided. DILUTION Results 1:3 Positive 1:6 Positive 1:12 Positive 1:24 Negative 1:48 Negative

Positive 1:12

What has happened in an antibody titer, if tube #5-7 shows a stronger reaction that tube #1-4?

Prozone reaction

Nephelometry is based on the principle of:

Turbidity resulting from specific antigen-coated latex particles agglutinated by corresponding antibody

Representative assays in the category of treponemal methods include the listed assay except?

Veneral Disease Research Laboratory Test

Flow cytometry is a useful tool in the study all of the following disorders, EXCEPT? HIV Leukemia Viral hepatitis Lymphoma

Viral hepatitis

The antinuclear antibody (ANA) test pattern is characterized by staining of discrete speckles in the nucleus of the interphase cells (a) the discrte speckling also in the chromosomal area of the metaphase mitotic (b) when viewed using fluorescent microscopy.

centromere pattern

Identify the antinuclear antibody (ANA) pattern in this microscopic image.

speckled

When should acute and convalescent blood specimens be collected from a patient for the detection of antibody concentration related to a specific infectious disease?

2 weeks apart

Which of the following statement is true regarding anti-nuclear antibodies?.

95% of patients with SLE will test positive for ANAs

Which two of the following tests are helpful for documenting previous streptococcal throat and skin infection?

ASO titer & anti-DNase B

What ANA staining pattern is demonstrated in this microscopic, fluorescent test image?

Centromere

Which of the following microscopic techniques is best suited for direct examination of the infectious agent of syphilis?

Darkfield microscopy

Direct examination of treponemes can be performed by:

Darkfield microscopy examination

All of the following are uses of nucleic acid tests for HIV infection EXCEPT?

Determine the degree of immune suppression caused by HIV

A nasopharynegeal specimen is processed and fixed onto a microscope slide. Next, fluorescein-conjugated antibody is added to the slide . The specimen is incubated with the labeled antibody, washed, and then observed for fluorscence. Which of the following techniques best describes this process?

Direct immunofluorescence

Which of the following best describes the methodology for FISH?

Direct nucleic acid test uses RNA northern blot or DNA southern blot to detect variations

When are data collected in a real time PCR procedure?

During nucleic acid amplification

Which of the following serological tests would be used for the diagnosis of Q-fever?

EIA or indirect immunoflourescence

For the diagnosis of SLE which of the following test principles provides the highest specificity?

ELISA

Which of the following is a confirmatory test for syphilis?

FTA-ABS

Which testing method is appropriate for identifying specific allergens?

Radioallergosorbent test (RAST)

What molecular technique is appropriate for HIV-1 genotyping?

Reverse transcriptase PCR

A patient had a differential diagnosed of SLE LAB RESULTS ANA= Positive (homogeneous pattern) titer= 1:320 RA= positive Complement= decreased

Ribonucleic protein (RNP) antibodies

Which of the following would be considered most significant as it relates to serological testing:

Rise of antibody titers is diagnostic

Antinuclear antibody (ANA) pattern is characterized by granular staining in the neclei of the interphase cells. There is also an absence of staining in the chromosome area of the methaphase mitotic cells. The slide is viewed using fluorescent microscopy.

SPECKLED

Important applications of PCR include the following with the general exception of:

Search for mutations with large deletions

Which method remains the " gold standard" for ANA detection?

Slide-based immunofluorescent assay (IFA)

There are two patterns present in this microscopic field from an antinuclear antibody ANA test. The test is viewed using fluorescent microscopy.

Speckled and homogenous

The VDRL and RPR are used to provide presumptive identification of which infection?

Syphilis

When a speckled Nuclear Antibody (ANA) pattern is observed, what follow-up test for antibodies related to SLE is not beneficial?

Testing for antibodies to U1RNP+ and dcSSC

Which modified PCR technique or other method of amplification is used to detect Mycobacterium tuberculosis?

Transcription -Mediated Amplification