ISBB

100問 • 1年前

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Which two organs are considered the primary lymphoid organs in which immunocompetent cells originate and mature? A. Thyroid and Peyer’s patches B. Thymus and bone marrow C. Spleen and mucosal-associated lymphoid tissue (MALT) D. Lymph nodes and thoracic duct

B. Thymus and bone marrow

What type of B cells are formed after antigen stimulation? A. Plasma cells and memory B cells B. Mature B cells C. Antigen-dependent B cells D. Receptor-activated B cells

A. Plasma cells and memory B cells

T cells travel from the bone marrow to the thymus for maturation. What is the correct order of the maturation sequence for T cells in the thymus? A. Bone marrow to the cortex; after thymic education, released back to peripheral circulation B. Maturation and selection occur in the cortex; migration to the medulla; release of mature T cells to secondary lymphoid organs C. Storage in either the cortex or medulla; release of T cells into the peripheral circulation D. Activation and selection occur in the medulla; mature T cells are stored in the cortex until activated by antigen

B. Maturation and selection occur in the cortex; migration to the medulla; release of mature T cells to secondary lymphoid organs

Which cluster of differentiation (CD) marker appears during the first stage of T-cell development and remains present as an identifying marker for T cells? A. CD1 B. CD2 C. CD3 D. CD4 or CD8

B. CD2

Which markers are found on mature, peripheral helper T cells? A. CD1, CD2, CD4 B. CD2, CD3, CD8 C. CD1, CD3, CD4 D. CD2, CD3, CD4

D. CD2, CD3, CD4

Which T cell expresses the CD8 marker and acts specifically, to kill tumors or virally infected cells? A. Helper T B. T suppressor C. T cytotoxic D. T inducer/suppressor

C. T cytotoxic

How are cytotoxic T cells (TC cells) and natural killer (NK) cells similar? A. Require antibody to be present B. Effective against virally infected cells C. Recognize antigen in association with HLA class II markers D. Do not bind to infected cells

B. Effective against virally infected cells

What is the name of the process by which phagocytic cells are attracted to a substance such as a bacterial peptide? A. Diapedesis B. Degranulation C. Chemotaxis D. Phagotaxis

C. Chemotaxis

Which complement component is found in both the classic and alternative pathways? A. C1 B. C4 C. Factor D D. C3

D. C3

Which immunoglobulin(s) help(s) initiate the classic complement pathway? A. IgA and IgD B. IgM only C. IgG and IgM D. IgG only

C. IgG and IgM

How is complement activity destroyed in vitro? A. Heating serum at 56°C for 30 min B. Keeping serum at room temperature of 22°C for 1 hour C. Heating serum at 37°C for 45 min D. Freezing serum at 0°C for 24 hours

A. Heating serum at 56°C for 30 min

Which region of the immunoglobulin molecule can bind antigen? A. Fab B. Fc C. CL D. CH

A. Fab

What is the purpose of C3a, C4a, and C5a, the split products of the complement cascade? A. To bind with specific membrane receptors of lymphocytes and cause release of cytotoxic substances B. To cause increased vascular permeability, contraction of smooth muscle, and release of histamine from basophils C. To bind with membrane receptors of macrophages to facilitate phagocytosis and the removal of debris and foreign substances D. To regulate and degrade membrane cofactor protein after activation by C3 convertase

B. To cause increased vascular permeability, contraction of smooth muscle, and release of histamine from basophils

Which region determines whether an immunoglobulin molecule can fix complement? A. VH B. CH C. VL D. CL

B. CH

Which immunoglobulin class(es) has (have) a J chain? A. IgM B. IgE and IgD C. IgM and sIgA D. IgG3 and IgA

C. IgM and sIgA

Which immunoglobulin appears first in the primary immune response? A. IgG B. IgM C. IgA D. IgE

B. IgM

Which immunoglobulin appears in highest titer in the secondary response? A. IgG B. IgM C. IgA D. IgE

A. IgG

Which immunoglobulin can cross the placenta? A. IgG B. IgM C. IgA D. IgE

A. IgG

Which immunoglobulin cross links mast cells to release histamine? A. IgG B. IgM C. IgA D. IgE

D. IgE

All of the following are functions of immunoglobulins except: A. Neutralizing toxic substances B. Facilitating phagocytosis through opsonization C. Interacting with TC cells to lyse viruses D. Combining with complement to destroy cellular Antigens

C. Interacting with TC cells to lyse viruses

Which of the following cell surface molecules is classified as an MHC class II antigen? A. HLA-A B. HLA-B C. HLA-C D. HLA-DR

D. HLA-DR

Which of the following are products of HLA class III genes? A. T-cell immune receptors B. HLA-D antigens on immune cells C. Complement proteins C2, C4, and Factor B D. Immunoglobulin VL regions

C. Complement proteins C2, C4, and Factor B

What molecule on the surface of most T cells recognizes antigen? A. IgT, a four-chain molecule that includes the tau heavy chain B. MHC protein, a two-chain molecule encoded by the HLA region C. CD3, consisting of six different chains D. TcR, consisting of two chains, alpha and beta

D. TcR, consisting of two chains, alpha and beta

The T-cell antigen receptor is similar to immunoglobulin molecules in that it: A. Remains bound to the cell surface and is never secreted B. Contains V and C regions on each of its chains C. Binds complement D. Can cross the placenta and provide protection to a fetus

B. Contains V and C regions on each of its chains

Toll-like receptors are found on which cells? A. T cells B. Dendritic cells C. B cells D. Large granular lymphocytes

B. Dendritic cells

Macrophages produce which of the following proteins during antigen processing? A. IL-1 and IL-6 B. γ-Interferon C. IL-4, IL-5, and IL-10 D. Complement components C1 and C3

A. IL-1 and IL-6

T regulator cells, responsible for controlling autoimmune antibody production, express which of the following phenotypes? A. CD3, CD4, CD8 B. CD3, CD8, CD25 C. CD3, CD4, CD25 D. CD8, CD25, CD56

C. CD3, CD4, CD25

A superantigen, such as toxic shock syndrome toxin-1 (TSST-1), bypasses the normal antigen processing stage by binding to and cross linking: A. A portion of an immunoglobulin molecule and complement component C1 B. Toll-like receptors and an MHC class 1 molecule C. A portion of an immunoglobulin and a portion of a T-cell receptor D. A portion of a T-cell receptor and an MHC class II molecule

D. A portion of a T-cell receptor and an MHC class II molecule

The interaction between an individual antigen and antibody molecule depends upon several types of bonds such as ionic bonds, hydrogen bonds, hydrophobic bonds, and van der Waals forces. How is the strength of this attraction characterized? A. Avidity B. Affinity C. Reactivity D. Valency

B. Affinity

A laboratory is evaluating an enzyme-linked immunosorbent assay (ELISA) for detecting an antibody to cyclic citrullinated peptide (CCP), which is a marker for rheumatoid arthritis. The laboratory includes serum from healthy volunteers and patients with other connective tissue diseases in the evaluation. These specimens determine which factor of the assay? A. Sensitivity B. Precision C. Bias D. Specificity

D. Specificity

The detection of precipitation reactions depends on the presence of optimal proportions of antigen and antibody. A patient’s sample contains a large amount of antibody, but the reaction in a test system containing antigen is negative. What has happened? A. Performance error B. Low specificity C. A shift in the zone of equivalence D. Prozone phenomenon

D. Prozone phenomenon

Which part of the radial immunodiffusion (RID) test system contains the antisera? A. Center well B. Outer wells C. Gel D. Antisera may be added to any well

C. Gel

What is the interpretation when an Ouchterlony plate shows crossed lines between wells 1 and 2 (antigen is placed in the center well and antisera in wells 1 and 2)? A. No reaction between wells 1 and 2 B. Partial identity between wells 1 and 2 C. Nonidentity between wells 1 and 2 D. Identity between wells 1 and 2

C. Nonidentity between wells 1 and 2

Why is a chemiluminescent immunoassay (CIA) or enzyme immunoassay (EIA) the method of choice for detection of certain analytes, such as hormones, normally found in low concentrations? A. Because of low cross reactivity B. Because of high specificity C. Because of high sensitivity D. Because test systems may be designed as both competitive and noncompetitive assays

C. Because of high sensitivity

What comprises the indicator system in an indirect ELISA for detecting antibody? A. Enzyme-conjugated antibody + chromogenic substrate B. Enzyme conjugated antigen + chromogenic substrate C. Enzyme + antigen D. Substrate + antigen

A. Enzyme-conjugated antibody + chromogenic substrate

What outcome results from improper washing of a tube or well after adding the enzyme–antibody conjugate in an ELISA system? A. Result will be falsely decreased B. Result will be falsely increased C. Result will be unaffected D. Result is impossible to determine

B. Result will be falsely increased

What would happen if the color reaction phase is prolonged in one tube or well of an ELISA test? A. Result will be falsely decreased B. Result will be falsely increased C. Result will be unaffected D. Impossible to determine

B. Result will be falsely increased

Which type of nephelometry is used to measure immune complex formation almost immediately after reagent has been added? A. Rate B. Endpoint C. Continuous D. One dimensiona

A. Rate

The absorbance of a sample measured by ELISA is greater than the highest standard. What corrective action should be taken? A. Extrapolate an estimated value from the highest reading B. Repeat the test using a standard of higher concentration C. Repeat the assay using one half the volume of the sample D. Dilute the test sample

D. Dilute the test sample

A patient was suspected of having a lymphoproliferative disorder. After several laboratory tests were completed, the patient was found to have an IgMκ paraprotein. In what sequence should the laboratory tests leading to this diagnosis have been performed? A. Serum protein electrophoresis (SPE) followed by immunofixation electrophoresis (IFE) B. Immunoglobulin levels followed by SPE C. Total lymphocyte count followed by immunoglobulin levels D. Immunoglobulin levels followed by urine protein electrophoresis

A. Serum protein electrophoresis (SPE) followed by immunofixation electrophoresis (IFE)

An IFE performed on a serum sample showed a narrow dark band in the lanes containing anti-γ and anti-λ. How should this result be interpreted? A. Abnormally decreased IgG concentration B. Abnormal test result demonstrating monoclonal IgGλ C. Normal test result D. Impossible to determine without densitometric quantitation

B. Abnormal test result demonstrating monoclonal IgGλ

An immunofluorescence microscopy assay (IFA) was performed, and a significant antibody titer was reported. Positive and negative controls performed as expected. However, the clinical evaluation of the patient was not consistent with a positive finding. What is the most likely explanation of this situation? A. The clinical condition of the patient changed since the sample was tested B. The pattern of fluorescence was misinterpreted C. The control results were misinterpreted D. The wrong cell line was used for the tes

B. The pattern of fluorescence was misinterpreted

What corrective action should be taken when an indeterminate pattern occurs in an indirect IFA? A. Repeat the test using a larger volume of sample B. Call the physician C. Have another medical laboratory scientist read the slide D. Dilute the sample and retest

D. Dilute the sample and retest

Which statement best describes passive agglutination reactions used for serodiagnosis? A. Such agglutination reactions are more rapid because they are a single-step process B. Reactions require the addition of a second antibody C. Passive agglutination reactions require biphasic incubation D. Carrier particles for antigen such as latex particles are used

D. Carrier particles for antigen such as latex particles are used

What has happened in a titer, if tube Nos. 5–7 show a stronger reaction than tube Nos.1–4? A. Prozone reaction B. Postzone reaction C. Equivalence reaction D. Poor technique

A. Prozone reaction

What is the titer in tube No. 8 if tube No. 1 is undiluted and dilutions are doubled? A. 64 B. 128 C. 256 D. 512

B. 128

The directions for a slide agglutination test instruct that after mixing the patient’s serum and latex particles, the slide must be rotated for 2 minutes. What would happen if the slide were rotated for 10 minutes? A. Possible false-positive result B. Possible false-negative result C. No effect D. Depends on the amount of antibody present in the sample

A. Possible false-positive result

Which outcome indicates a negative result in a complement fixation test? A. Hemagglutination B. Absence of hemagglutination C. Hemolysis D. Absence of hemolysis

C. Hemolysis

What effect does selecting the wrong gate have on the results when cells are counted by flow cytometry? A. No effect B. Failure to count the desired cell population C. Falsely elevated results D. Impossible to determine

B. Failure to count the desired cell population

Which statement best describes immunophenotyping? A. Lineage determination by detecting antigens on the surface of the gated cells using fluorescent antibodies B. Identification of cell maturity using antibodies to detect antigens within the nucleus C. Identification and sorting of cells by front and sidescatter of light from a laser D. Analysis of cells collected by flow cytometry using traditional agglutination reactions

A. Lineage determination by detecting antigens on the surface of the gated cells using fluorescent antibodies

A flow cytometry scattergram of a bone marrow sample shows a dense population of cells located inbetween normal lymphoid and normal myeloid cells. What is the most likely explanation? A. The sample was improperly collected B. An abnormal cell population is present C. The laser optics are out of alignment D. The cells are most likely not leukocytes

B. An abnormal cell population is present

What substance is detected by the rapid plasma reagin (RPR) and Venereal Disease Research Laboratory (VDRL) tests for syphilis? A. Cardiolipin B. Anticardiolipin antibody C. Anti-T. pallidum antibody D. Treponema pallidum

B. Anticardiolipin antibody

What type of antigen is used in the RPR card test? A. Live treponemal organisms B. Killed suspension of treponemal organisms C. Cardiolipin D. Tanned sheep cells

C. Cardiolipin

Which of the following is the most sensitive test to detect congenital syphilis? A. VDRL B. RPR C. Microhemagglutinin test for T. pallidum (MHA-TP) D. Polymerase chain reaction (PCR)

D. Polymerase chain reaction (PCR)

A biological false-positive reaction is least likely with which test for syphilis? A. VDRL B. Fluorescent T. pallidum antibody absorption test (FTA-ABS) C. RPR D. All are equally likely to detect a false-positive Result

B. Fluorescent T. pallidum antibody absorption test (FTA-ABS)

A 12-year-old girl has symptoms of fatigue and a localized lymphadenopathy. Laboratory tests reveal a peripheral blood lymphocytosis, a positive RPR, and a positive spot test for IM. What test should be performed next? A. HIV test by ELISA B. VDRL C. Epstein–Barr virus (EBV) specific antigen test D. Treponema pallidum particle agglutination (TP-PA) test

D. Treponema pallidum particle agglutination (TP-PA) test

Which test is most likely to be positive in the tertiary stage of syphilis? A. FTA-ABS B. RPR C. VDRL D. Reagin screen test (RST)

A. FTA-ABS

What is the most likely interpretation of the following syphilis serological results? A. Neurosyphilis B. Secondary syphilis C. Syphilis that has been successfully treated D. Biological false positive

D. Biological false positive

Interpret the following quantitative RPR test results. A. Excess antibody, prozone effect B. Excess antigen, postzone effect C. Equivalence of antigen and antibody D. Impossible to interpret; testing error

A. Excess antibody, prozone effect

Tests to identify infection with HIV fall into which three general classification types of tests? A. Tissue culture, antigen, and antibody tests B. Tests for antigens, antibodies, and nucleic acid C. DNA probe, DNA amplification, and Western blot tests D. ELISA, Western blot, and Southern blot tests

B. Tests for antigens, antibodies, and nucleic acid

A woman who has had five pregnancies subsequently tests positive for HIV by Western blot. What is the most likely reason for this result? A. Possible cross-reaction with herpes or EBV antibodies B. Interference from medication C. Cross-reaction with HLA antigens in the antigen preparation D. Possible technical error

C. Cross-reaction with HLA antigens in the antigen preparation

Interpret the following results for HIV infection. A. Positive for antibodies to human immunodeficiency virus, HIV-1 B. Positive for antibodies to human immunodeficiency virus, HIV-2 C. Cross reaction; biological false-positive result D. Additional testing required

D. Additional testing required

What is the most likely explanation when antibody tests for HIV are negative but a polymerase chain reaction test performed 1 week later is positive? A. Probably not HIV infection B. Patient is in the “window phase” before antibody production C. Tests were performed incorrectly D. Clinical signs may be misinterpreted

B. Patient is in the “window phase” before antibody production

What criteria constitute the classification system for HIV infection? A. CD4-positive T-cell count and clinical symptoms B. Clinical symptoms, condition, duration, and number of positive bands on Western blot C. Presence or absence of lymphadenopathy D. Positive bands on Western blot and CD8-positive T-cell count

A. CD4-positive T-cell count and clinical symptoms

What is the main difficulty associated with the development of an HIV vaccine? A. The virus has been difficult to culture; antigen extraction and concentration are extremely laborious B. Human trials cannot be performed C. Different strains of the virus are genetically diverse D. Anti-idiotype antibodies cannot be developed

C. Different strains of the virus are genetically diverse

What is the advantage of 4th-generation rapid HIV tests over earlier rapid HIV tests? A. They use recombinant antigens B. They detect multiple strains of HIV C. They detect p24 antigen D. They are quantitative

C. They detect p24 antigen

Which method is used to test for HIV infection in infants who are born to HIV-positive mothers? A. ELISA B. Western blot test C. Polymerase chain reaction D. Viral culture

C. Polymerase chain reaction

What is the most likely cause when a Western blot or ELISA is positive for all controls and samples? A. Improper pipetting B. Improper washing C. Improper addition of sample D. Improper reading

B. Improper washing

What constitutes a diagnosis of viral hepatitis? A. Abnormal test results for liver enzymes B. Clinical signs and symptoms C. Positive results for hepatitis markers D. All of these options

D. All of these options

Which of the following statements regarding infection with hepatitis D virus is true? A. Occurs in patients with HIV infection B. Does not progress to chronic hepatitis C. Occurs in patients with hepatitis B D. Is not spread through blood or sexual contact

C. Occurs in patients with hepatitis B

All of the following hepatitis viruses are spread through blood or blood products except: A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis D

A. Hepatitis A

Which hepatitis B marker is the best indicator of early acute infection? A. HBsAg B. HBeAg C. Anti-HBc D. Anti-HBs

A. HBsAg

Which is the first antibody detected in serum after infection with hepatitis B virus (HBV)? A. Anti-HBs B. Anti-HBc IgM C. Anti-HBe D. All are detectable at the same time

B. Anti-HBc IgM

Which antibody persists in low-level carriers of hepatitis B virus? A. IgM anti-HBc B. IgG anti-HBc C. IgM anti-HBe D. IgG anti-HBs

B. IgG anti-HBc

Which hepatitis antibody confers immunity against reinfection with hepatitis B virus? A. Anti-HBc IgM B. Anti-HBc IgG C. Anti-HBe D. Anti-HBs

D. Anti-HBs

What is the most likely explanation when a patient has clinical signs of viral hepatitis but tests negative for hepatitis A IgM, hepatitis B surface antigen, and hepatitis C Ab? A. Tests were performed improperly B. The patient does not have hepatitis C. The patient may be in the “core window” D. Clinical evaluation was performed improperly

C. The patient may be in the “core window”

Which hepatitis B markers should be performed on blood products? A. HBsAg and anti-HBc B. Anti-HBs and anti-HBc C. HBeAg and HBcAg D. Anti-HBs and HBeAg

A. HBsAg and anti-HBc

Which test, other than serological markers, is most consistently elevated in viral hepatitis? A. Antinuclear antibodies B. Alanine aminotransferase (ALT) C. Absolute lymphocyte count D. Lactate dehydrogenase

B. Alanine aminotransferase (ALT)

If only anti-HBs is positive, which of the following can be ruled out? A. Hepatitis B virus vaccination B. Distant past infection with hepatitis B virus C. Hepatitis B immune globulin (HBIG) injection D. Chronic hepatitis B virus infection

D. Chronic hepatitis B virus infection

Interpret the following results for EBV infection: IgG and IgM antibodies to viral capsid antigen (VCA) are positive. A. Infection in the past B. Infection with a mutual enhancer virus such as HIV C. Current infection D. Impossible to interpret; need more information

C. Current infection

Which statement concerning non-Forssman heterophile antibody is true? A. It is not absorbed by guinea pig antigen B. It is absorbed by guinea pig antigen C. It does not agglutinate horse RBCs D. It does not agglutinate sheep RBCs

A. It is not absorbed by guinea pig antigen

Given a heterophile antibody titer of 224, which of the following results indicate IM?

Given a heterophile antibody titer of 224, which of the following results indicate serum sickness?

4. Given a heterophile antibody titer of 224, which of the following results indicate an error in testing?

Blood products are tested for which virus before being transfused to newborns? A. EBV B. Human T-lymphotropic virus II (HTLV-II) C. Cytomegalovirus (CMV) D. Hepatitis D virus

C. Cytomegalovirus (CMV)

What is the endpoint for the antistreptolysin O (ASO) latex agglutination assay? A. Highest serum dilution that shows no agglutination B. Highest serum dilution that shows agglutination C. Lowest serum dilution that shows agglutination D. Lowest serum dilution that shows no agglutination

B. Highest serum dilution that shows agglutination

Interpret the following ASO results: A. Positive Todd unit 125 B. Positive Todd unit 166 C. No antistreptolysin O present D. Impossible to interpret

A. Positive Todd unit 125

Which control shows the correct result for a valid ASO test? A. SLO control, no hemolysis B. Red cell control, no hemolysis C. Positive control, hemolysis in all tubes D. Hemolysis in both SLO and red cell control

B. Red cell control, no hemolysis

A streptozyme test was performed, but the result was negative, even though the patient showed clinical signs of a streptococcal throat infection. What should be done next? A. Either ASO or anti-deoxyribonuclease B (antiDNase B) testing B. Another streptozyme test using diluted serum C. Antihyaluronidase testing D. Wait for 3–5 days and repeat the streptozyme test

A. Either ASO or anti-deoxyribonuclease B (antiDNase B) testing

Rapid assays for influenza that utilize specimens obtained from nasopharyngeal swabs detect: A. IgM anti-influenza B. IgA anti-influenza C. IgA-influenza Ag immune complexes D. Influenza antigen

D. Influenza antigen

How can interfering cold agglutinins be removed from a test sample? A. Centrifuge the serum and remove the top layer B. Incubate the clot at 1°C–4°C for several hours, then remove serum C. Incubate the serum at 56°C in a water bath for 30 minutes D. Use an anticoagulated sample

B. Incubate the clot at 1°C–4°C for several hours, then remove serum

All tubes (dilutions) except the negative control are positive for cold agglutinins. This indicates: A. Contaminated red cells B. A rare antibody against red cell antigens C. The sample was stored at 4°C prior to separating serum and cells D. Further serial dilution is necessary

D. Further serial dilution is necessary

All positive cold agglutinin tubes remain positive after 37°C incubation except the positive control. What is the most likely explanation for this situation? A. High titer cold agglutinins B. Contamination of the test system C. Antibody other than cold agglutinins D. Faulty water bath

C. Antibody other than cold agglutinins

Which increase in antibody titer (dilution) best indicates an acute infection? A. From 1:2 to 1:8 B. From 1:4 to 1:16 C. From 1:16 to 1:256 D. From 1:64 to 1:128

C. From 1:16 to 1:256

Which of the following positive antibody tests may be an indication of recent vaccination or early primary infection for rubella in a patient with no clinical symptoms? A. Only IgG antibodies positive B. Only IgM antibodies positive C. Both IgG and IgM antibodies positive D. Fourfold rise in titer for IgG antibodies

B. Only IgM antibodies positive

Why is laboratory diagnosis difficult in cases of Lyme disease? A. Clinical response may not be apparent upon initial infection; IgM antibody may not be detected until 3–6 weeks after the infection B. Laboratory tests may be designed to detect whole Borrelia burgdorferi, not flagellar antigen found early in infection C. Most laboratory tests are technically demanding and lack specificity

A. Clinical response may not be apparent upon initial infection; IgM antibody may not be detected until 3–6 weeks after the infection

Serological tests for which disease may give a false positive result if the patient has Lyme disease? A. AIDS B. Syphilis C. Cold agglutinins D. Hepatitis C

B. Syphilis

In monitoring an HIV-infected patient, which parameter may be expected to be the most sensitive indicator of the effectiveness of antiretroviral treatment? A. HIV antibody titer B. CD4:CD8 ratio C. HIV viral load D. Absolute total T-cell count

C. HIV viral load

A renal transplant recipient is found to have a rising creatinine level and reduced urine output. The physician orders a “Urine PCR” assay. When you call to find out what organism the physician wants to identify, you are told: A. Hepatitis C virus B. Legionella pneumophila C. EBV D. BK virus

D. BK virus

100

A newborn is to be tested for a vertically transmitted HIV infection. Which of the following tests is most useful? A. HIV PCR B. CD4 count C. Rapid HIV antibody test D. HIV IgM antibody tes

A. HIV PCR

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Yves Laure Pimentel · 64問 · 2年前

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