Immunology Exam 2 ASCP

The primary purpose of neutrophil granules is to:

Provide microbicidal action.

When two consecutive controls are greater than ± 2 SD units from the mean, what should you do first?

Recalibrate, then repeat controls followed by patient specimen results if QC is acceptable.

What molecular technique is appropriate for HIV-1 genotyping?

Reverse Transcriptase Polymerase Chain Reaction

What order of draw should be used to collect the following tubes if plastic evacuated tubes with a regular blood collection needle (not a winged blood collection device)?

Light blue first, then serum tube, finally lavender tube

What information can you find on the label affixed to the primary container of a hazardous chemical?

Manufacturer's name and contact information

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

Poor specimen quality

What is the primary target of HBV?

Liver

Which of the following would ensure positive patient identification prior to specimen collection?

Patient's full name and hospital or medical record number.

What has happened in an antibody titer, if tubes #5-7 show a stronger reaction than tubes #1-4?

Prozone reaction

A kidney graft would have the BEST chance of survival post-transplantation if it were:

HLA identical, mixed lymphocyte culture (-), ABO identical.

A technologist put five (5) tubes in a test tube rack and put 3 mL of diluent in each tube. The tech then put 0.3 mL serum in the first tube and mixed it. Next, the tech then transferred 1 mL of the mixture from the first tube to the second tube. This process was carried on through tube number five (5). What is the dilution factor in tube number five?

2816

Skin and mucous membranes are important components of what part of the immune system?

Innate immunity

All of the following is true about real-time RT-PCR, EXCEPT?

It does not require the use of reverse transcriptase

What best describes the proper lifting procedure when lifting a heavy item that will help to prevent back injuries?

Keep the item close to the body, bend the knees, and lift with the legs.

Nephelometry and turbidimetry measure different properties of:

Light transmission and scatter by particles in suspension

Which of the following viruses or diseases is screened for in blood donors only using questions asked during the donor screening and selection process?

Malaria

Which of the following conditions is most likely when an oligoclonal band is seen in CSF electrophoresis without a corresponding serum peak?

Multiple sclerosis

Which of the following BEST describes the relation of nephelometry to turbidimetry?

Nephelometry directly measures the amount of light scattered by particles in solution, and turbidimetry measures the decrease in incident-light intensity

Which of the following types of lymphocytes express CD4?

Only T-helper cells

Phagocytosis by cells of the mononuclear phagocytic system is greatly enhanced by which of the following?

Opsonins

How does the laboratory immunologic assessment of Waldenstrom's Primary Macroglobulinemia differ from other monoclonal gammopathies?

Overproduction of IgM antibodies.

Examples of cytokines originating from activated T-cells include:

IL-2, IL-3

General Hospital is considering the addition of a new chemistry panel containing 12 tests. The laboratory is asked to calculate the total cost of quality control per new chemistry test panel. Quality control must be performed 3 times per day (every 8 hours). The labor cost per quality control test for this panel is $2.63. A month's worth of quality control reagent costs $354.00. What is the total quality control cost per new chemistry test panel if 76,000 of these new panels are performed each year?

$0.09

All of the following are features of systemic lupus erythematosus (SLE), EXCEPT:

Increased serum complement

The vast MAJORITY of would-be invaders are killed or inactivated primarily by which part of the immune system?

Innate immunity

What is the effect of a compound on the accuracy of detection of a particular analyte?

Interference

The images below represent the results of normal and abnormal levels of control that are tested daily for a particular analyte. On which day should the run be rejected if Westgard rules are used to evaluate quality control?

13

The preparation of a Levey-Jennings quality control chart for any constituent of serum requires:

A minimum of 20-30 analyses of control serum over a period of 20-30 days.

A cytokine can be described as:

A soluble protein that regulates the immune response

Given the following hepatitis B serology results, what is the immune status of the patient? HBsAg: positive HBeAg: positive Anti-HBc IgM: positive Anti-HBs: negative

Acute infection

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

Amplification of DNA for northern blot

Which of the following is responsible for the humoral immune response:

B lymphocytes

What biosafety level (BSL) is required by the Centers for Disease Control and Prevention (CDC) for working with Mycobacterium tuberculosis, if there is a possibility that aerosols might be released?

BSL-3

Which of the following choices best describes the primary function of antibodies?

Binds with antigen

Which of the following is the "activation unit" in the classical complement pathway?

C4, C2, C3

Which of the following tests would be most affected by microclots in an EDTA tube drawn for a CBC?

Platelet count

Which one of the following statements concerning phagocytosis is FALSE?

Cells are only capable of phagocytizing bacteria.

The least immunogenic transplant tissue is:

Corneas

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)

Which nitrogen base would bind with a guanine nucleotide in forming double-stranded DNA?

Cytosine

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

Dark-field microscopy

What is defined as the ability of the test to detect a given disease or condition?

Diagnostic sensitivity

Which part of the spectrophotometer is used for the isolation of individual wavelengths of light?

Diffraction grating

When performing controls for the morning run in coagulation, the normal control is within acceptable limits for both the PT and APTT, but the abnormal control is out of range for both procedures. Which of the following would be an appropriate action to take?

Document QC, repeat the abnormal control, troubleshoot if necessary; report patient results only when both controls are within acceptable ranges

What is the correct procedure when using a winged collection device (butterfly) to draw a light-blue top tube intended for a coagulation test if this is the first tube that will be collected in the draw?

Draw and discard a waste light-blue top tube before the tube that will be used for coagulation studies.

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

What condition would be suspected in an asymptomatic patient with greater than 20% atypical (reactive) lymphocytes on their peripheral blood smear?

Epstein-Barr virus infection

What is the intent of the Health Insurance Portability & Accountability Act (HIPAA) of 1996?

Establish security and privacy standards

Concerning antigen-antibody reactions, the prozone effect causes which of the following results?

False negative

Isopropyl alcohol is considered (a):

Flammable

The infectious disease process in which large numbers of activated macrophages and histiocytes are collected at the site of inflammation is called?

Granulomatous

The antigen marker most closely associated with transmission of HBV infections is:

HBeAg

What sero-marker is the first marker to become positive in Hepatitis B and is associated with the infective stage?

HBs antigen

Which is the first marker (antigen or antibody) which will become positive after exposure to Hepatitis B?

HBsAg

The most frequently encountered immunoglobulin demonstrated in patients with Multiple Myeloma is:

Ig G

Which antibody class is best described with that characteristic that it is the only one capable of residing in mucosal linings?

IgA

The antibody mediator associated with a Type I Hypersensitivity Reaction is:

IgE

Which immunoglobulin is associated with anaphylactic shock?

IgE

The immunoglobulin class responsible for the etiology of Hemolytic Disease of the Fetus and Newborn (HDFN) is:

IgG

A primary immune response is generally associated with which antibody?

IgM

CD5 antigen is normally found on which of the following lymphocyte populations?

Mature T cells

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

May demonstrate anti-mitochondrial antibodies seen primary biliary cirrhosis

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

Monitoring course of treatment

Removal of which of these organs may be a last resort treatment for a patient whose platelet count is less than 30 x 109/L as a result of chronic idiopathic thrombocytopenic purpura (ITP)?

Spleen

T lymphocytes are characterized by all of the following functions EXCEPT which?

Synthesize antibody

Which of the following activities may lead to a HIPAA violation lawsuit?

Throwing laboratory test requests into the regular trash.

Following the treatment of an IgG molecule with papain, which of the following will remain?

Two Fab fragments each with a light chain and a partial heavy chain attached with a disulfide bond

Which one of the following statements about fingersticks is correct?

Use the middle or fourth finger.

What is the half-life of IgG? Why is the duration of the half-life significant?

18-23 days; it binds with neonatal Fc receptor.

A phlebotomist who is performing venipuncture on a small delicate hand vein should choose a needle with a gauge number of:

23

Within what period of time after performance of the tuberculin skin test (TST) should the result be read?

48-72 hours

Which statement refers to the coefficient of variation?

A measure of imprecision that is expressed as a percentage.

A hapten can BEST be described as:

A nonimmunogenic material capable of stimulating an immune response only when bound to a carrier protein

The characteristics of an acute phase protein include the following EXCEPT:

Acute phase proteins are synthesized slowly in response to tissue injury.

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

Antistreptolysin O (ASO)

The term "Contaminated Sharps" refers to:

Any contaminated object that can penetrate the skin

All of the following are Lancefield carbohydrate antigens found on beta hemolytic Streptococcus species. All of the following antigens are found on organisms from the Streptococcus anginosus group EXCEPT?

B

When an automated or semi-automated method is used to read urine reagent strips, quality control testing must be performed at least:

Every day of patient testing and when a new bottle is opened.

All of the listed disorders are organ non-specific autoimmune diseases EXCEPT:

Hashimoto's disease

False positive results for HIV antibody are most likely to occur in patients that:

Have an autoimmune disorder

What section of an immunoglobulin molecule is responsible for the differences between immunoglobulin classes?

Heavy chains

Holding pressure on the puncture site after withdrawing the needle may prevent:

Hematoma formation

All of the following diseases are associated with autoantibodies, EXCEPT?

Hemolytic disease of the newborn

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 rickettsii, is MOST reliably diagnosed by which laboratory technique?

IFA testing

Which of the following immunoglobulin classes is chiefly responsible for the degranulation of mast cells and basophils?

IgE

A secondary immune response is generally associated with which of the following antibodies?

IgG

Which class of antibody can agglutinate erythrocytes (RBCs) after anti-human globulin (AHG) is added to the test tube?

IgG

Which of the following antibody types is chiefly seen in the primary immune response:

IgM

All of the following conditions are associated with a polyclonal (broadbased) increase in gamma globulins except?

Immunodeficiency

What is another name used to designate a fully committed B-lymphocyte:

Plasma cell

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

Which is the incorrect statement about sample labeling requirements?

Prelabeled tubes should be used.

Which of the following types of molecules is most likely to be antigenic/immunogenic?

Proteins

Which one of the following are normal genes that induce DNA synthesis, promote cell division, and inhibit cell death?

Proto-oncogenes

All of the following are responsibilities of a clinical laboratory supervisor, EXCEPT?

Providing clinical consultation to physicians about patient care

Which of the following blood smear observations would support the diagnosis of Multiple Myeloma if a patient demonstrated plasma cells in his bone marrow and had an elevated serum IgG?

Rouleaux formation

Important applications of polymerase chain reaction (PCR) include the following with the general exception of:

Search for mutations with large deletions

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

Syphilis

Jane Doe is a 30-year-old female who felt tired for several months, had pain in the joints of her fingers, and recently developed a dermatitis following exposure to the sun. The following test results were obtained on a blood sample drawn during the initial evaluation: Total Protein = 8.4 gm/dL (N = 6.0-8.0 gm/dL)ANA >1:2560; speckled patternCRP = positiveC3 = 40 mg/dL (N = 80-180 mg/dL)C4 = 5 mg/dL (N = 15-45 mg/dL) Based on the clinical and laboratory findings, what disease should be suspected?

Systemic Lupus Erythematosus (SLE)

Which T lymphocyte expresses the CD8+ marker and acts specifically to kill tumor or virally-infected cells?

T cytotoxic

Contact dermatitis is mediated by:

T lymphocytes

What is the primary target of HIV (human immunodeficiency virus)?

T-helper cells

Which of the following is a TRUE statement when performing maintenance or repair tasks on electrical equipment?

Tagout is the placement of a tag on the energy-isolating device notifying staff: "Do Not Operate this Equipment."

What are the two general categories of nucleic acid amplification (NAA) techniques?

Target amplification and signal amplification

The purified protein derivative (PPD) test is also known as:

Targeted tuberculin testing

According to _________ , all workplaces, including the laboratory, must have a fire prevention plan.

The Occupational Safety and Health Administration (OSHA)

Koch's postulates include all of the following EXCEPT for which statement?

The isolated organism, when injected into a human host, will produce the disease.

Which of the following best describes single nucleotide polymorphisms, SNPs?

The most common alteration and a single base change

A chemical reaction that is utilized by many different analytical methods involves:

The reduction of NAD to NADH

Which of the following best describes the methodology for FISH?

Uses directly labeled fluorescent nucleotides or probes with reporter molecules that are indirectly detected by fluorescent antibodies or affinity molecules

Flow cytometry is a useful tool in the study all of the following disorders, EXCEPT?

Viral hepatitis

Good Manufacturing Practices applies to all of the following, EXCEPT:

Waste