Immunology

What can be done to make a hapten behave like an antigen? A. Denature the protein B. Bind to protein C. Bind to lipid D. Bind to carbohydrate

B

During which stage of a syphilis infection will a patient develop the painless chancre? A. First stage B. Second stage C. Latent stage D. Third stage

A

In what trimester is there the greatest risk for the manifestation of complications in maternal rubella infection? A. First trimester B. Second trimester C. Third trimester D. Delivery

A

Q: In an standard electrophoretic separation, what zone appears first (anodal end) on the densitometric pattern? A. Albumin B. Alpha 1 globulins C. Alpha 2 globulins D. Beta globulins

A

The MHC I genes encode for: A. HLA-A, B, C B. HLA-DR, DQ, DP C. Complement D. Cytokines

A

The following characteristics are applicable to Interferon-Gamma Release Assays (IGRAs) except: A. Can be used in patients with active tuberculosis disease symptoms B. Preferable for patients who have received a bacillus Calmette-Guerin (BCG) vaccination C. Can be used instead of purified protein derivative (PPD) D. Cannot differentiate latent TB from active tuberculosis infection

A

This ANA test pattern is characterized by staining of discrete speckles in the nucleus of the interphase cells and discrete speckling also in the chromosomal area of the metaphase mitotics when viewed using fluorescent microscopy. This image represents which of the following patterns? A. Centromere pattern B. Peripheral or rim pattern C. Speckled pattern D. Multiple nuclear dots

A

What is the correct sequence of the immunologic Epstein-Barr virus (EBV) response in infectious mononucleosis? VCA = viral capsid antigen VCA/IgM = viral capsid antibody (IgM) EA = early antigen EBNA = Epstein-Barr nuclear antigen A. VCA, EBNA, VCA/IgM, EA B. EA, EBNA, VCA, VCA/IgM C. VCA/IgM, EBNA, VCA, EA D. EBNA, VCA, EA, VCA/IgM

A

What molecular technique is appropriate for HIV-1 genotyping? A. Reverse transcriptase PCR B. Multiplex PCR C. Real-time PCR D. Strand displacement amplification

A

What part of an immunoglobulin molecule contains the heavy chain? A. Bottom part of "Y" B. Center part of "Y" C. Both top parts of "Y" D. The tips of "Y"

A

Which immunoglobulin is associated with anaphylactic shock? A. IgA B. IgD C. IgE D. IgG

A

A kidney graft would have the best chance of survival post-transplantation if it were: A. HLA non-identical, mixed lymphocyte culture (+), ABO identical B. HLA identical, mixed lymphocyte culture (+), ABO identical C. HLA identical, mixed lymphocyte culture (-), ABO identical D. HLA identical, mixed lymphocyte culture (-), ABO non-identical

C

Skin and mucous membranes are important components of what part of the immune system? A. Cell mediated immunity B. Adaptive immunity C. Innate immunity D. Acquired immunity

C

VDRL and RPR are examples of which of the following types of test methodologies? A. ELISA B. Immunofluorescence C. Flocculation D. Hemagglutination

C

What has happened in an antibody titer, if tubes 5-7 show a stronger reaction than tubes 1-4? A. Poor technique B. Post-zone reaction C. Pro-zone reaction D. Zone of equivalence reaction

C

What is the process of monoclonal antibody production? A. Stimulation of activated T cells B. Fusion of plasma cell secretions C. Fusion of antibody specific lymphocyte and myeloma cell D. Multiplication of cytotoxic T cells

C

Which of the following antibody types is chiefly seen in the primary immune response? A. IgG B. IgA C. IgM D. IgD

C

Which of the following is responsible for the humoral immune response? A. Neutrophils B. Basophils C. B lymphocytes D. Monocytes

C

Which of the following kappa/lambda ratios are found in normal B cells? A. 4:1 B. 3:1 C. 2:1 D. 1:1

C

You are performing a manual antibody titer in a clinical lab. You have made serial dilutions of a patient's plasma sample and you are looking for anti-streptolysin O antibodies. The first tube contains pure patient plasma. The second tube contains a 1:2 dilution of the first tube. The third tube contains a 1:2 dilution of the second tube and so on. The patient's antibodies no longer give visible reaction in tube 5, indicating their titer is tube 4 (or the last tube where there is a positive result). What is the concentration of antibodies in tube 4 compared to the concentration in tube 1? A. The concentration of antibodies in tube 4 is the same as the concentration of antibodies in tube 1. B. The concentration of antibodies in tube 4 is about 1/4 the concentration of antibodies in tube 1. C. The concentration of antibodies in tube 4 is 1/8 the concentration of antibodies in tube 1. D. The concentration of antibodies in tube 4 is 4 times the concentration of antibodies in tube 1.

C

A traveler is being evaluated at a local hospital for GI pain, fever, and diarrhea. The patient has recently returned from a month-long visit to SE Asia. The patient has no recent history of sexual activity or IV drug use but did describe conditions of poor sanitation where they were visiting. If liver function test results were elevated and bilirubinuria was noted, which of the following would be the next logical test to order A. ELISA test for the Hepatitis B surface antigen (HBsAg) B. Recombinant immunoblot assay (RIBA) test for Hepatitis C C. Western Blot test for HIV D. ELISA testing for Hepatitis A antigens in the stool

D

All of the listed disorders are organ non-specific autoimmune diseases except: A. Systemic lupus erythematosus (SLE) B. Systemic sclerosis (SSc) C. Rheumatoid arthritis (RA) D. Hashimoto's disease

D

Antigen processing is primarily accomplished by what type of cells? A. Basophils B. Eosinophils C. Polymorphonuclear neutrophils D. Macrophages

D

Severe combined immunodeficiency (SCID) is characterized by all of the following immunodeficiencies except: A. T-cell reduction or dysfunction B. B-cell reduction or dysfunction C. Natural killer (NK) cell reduction D. A deficiency of stem cells

D

Significant risk factors for potential development of graft-versus-host disease (GVHD) include the following factors except: A. Source of immunocompetent lymphocytes B. Human leukocyte antigen (HLA) differences C. Inability to reject donor lymphocytes D. A strong ability of the host to destroy foreign lymphocytes

D

The enzymatic process in each PCR cycle consists of the following steps except: A. DNA denaturation B. Primer annealing C. Extension of primed DNA sequence D. Analysis of PCR product

D

This ANA pattern is characterized by granular staining in the nuclei of the interphase cells. There is also an absence of staining in the chromosomal area of the metaphase mitotic cells. The slide is viewed using fluorescent microscopic. Which pattern is this? A. Homogeneous B. Speckled C. Nucleolar D. Centromere

D

What part of an immunoglobulin (Ig) molecule exists as kappa or lambda chains? A. Fc B. Fab C. Heavy chains D. Light chains

D

Which branch of the immune system has an immediate response on first exposure to a foreign antigenic stimulus? A. Cell-mediated B. Specific C. Humoral D. Innate

D

Which of the following blood smear observations would support the diagnosis of MM if a patient demonstrated plasma cells in his bone marrow and had an elevated serum IgG? A. Anisocytosis B. Target cells C. Microcytic RBCs D. Rouleaux formation

D

When evaluating the patterns of fluorescent ANA testing, cytoplasmic patterns: A. Are not considered in pattern assessment B. May demonstrate anti-mitochondrial antibodies seen in primary biliary cirrhosis C. Indicate the presence of anti-histone antibodies D. Indicate the presence of anti-Smith antibodies

B

When should acute and convalescent blood specimens be collected from a patient for the detection of antibody concentration related to a specific infectious disease? A. 2 weeks apart B. 4 weeks apart C. 3 months apart D. 6 months apart

B

Which of the following abnormal WBCs is most commonly found in a peripheral smear of a patient of a patient with infectious mono? A. Monocytes with vacuoles B. Reactive lymphocytes C. Hypersegmented neutrophils D. Giant platelets

B

Which of the following statements is true regarding anti-nuclear antibodies? A. They are highly specific for patients with SLE B. 95% of patients with SLE will test positive for ANAs C. Reactions using HEp-2 cells will demonstrate diffuse, speckled, peripheral and starburst patterns D. Results are diagnostic with no further testing necessary

B

Concerning antigen-antibody reactions, the prozone effect causes which of the following results? A. False positive B. False negative C. No reaction at all D. Mixed field reaction

B

Direct examination of treponemes can be performed by: A. Light microscopy examination B. Dark field microscopy examination C. VDRL testing D. Rapid plasma reagin (RPR) testing

B

The causative agent of infectious mononucleosis attaches to a receptor on which of the following cells? A. T helper cell B. B lymphocyte C. T suppressor cell D. NK cell

B

Which complement pathway and a related initiator can activate complement? A. Classic pathway; antigen-IgG antibody complexes B. Classic pathway; tumor cells C. Alternative pathway; certain viruses and gram-negative bacteria D. Mannose-lectin pathway; apoptotic cells

A

Which of the following is used to determine if a person has had a recent infection with Strep pyogenes? A. Anti-streptolysin O (ASO) B. Hyaluronidase C. M-protein D. Streptococcal pyrogenic exotoxin

A

The infectious disease process in which large numbers of activated macrophages and histiocytes are collected at the site of inflammation is called: A. Purulent B. Granulomatous C. Chronic D. Opportunistic

B

What is the primary target of HBV? A. Heart B. Liver C. Lungs D. Brain

B

When a polyclonal gammpathy is compared to a monoclonal gammopathy, a patient with a polyclonal gammopathy has: A. A single class and type of immunoglobulin B. Elevated levels of several classes of immunoglobulin molecules C. Bence Jones protein in the urine D. M spike on serum protein electrophoresis

B

A hapten can best be described as: A. A carrier molecule for an antigen that is not antigen alone B. A non-immunogenic material capable of stimulating an immune response only when bound to a carrier protein C. An immunoglobulin functional only in the presence of complement D. Half of an immunoglobulin molecule

B

A physician suspects his patient might have rheumatoid arthritis. Which of the following markers should be ordered? A. Anti-mitochondrial antibodies B. Anti-IgG C. Anti-neutrophilic anitbodies D. Anti-myocardial antibodies

B

A representative congenital monocyte-macrophage functional disorder is: A. Chediak-Higashi syndrome B. Gaucher's disease C. Leukocyte adhesion deficiency D. Systemic inflammation response syndrome (SIRS)

B

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

B

Which of the following immunoglobulin classes is chiefly responsible for the degranulation of mast cells and basophils? A. IgG B. IgA C. IgM D. IgE

D

Which of the following tests is used to confirm a syphilis infection after another method tests positive for syphilis? A. Rapid plasma reagin (RPR) test B. Veneral disease research laboratory (VDRL) test C. Dark-field examination D. T. pallidum particle agglutination (TP-PA) test

D

Which of the following types of molecules is most likely to be antigenic/immunogenic? A. Nucleic acids B. Carbohydrates C. Lipids D. Proteins

D