Biomedical Laboratory Diagnostics
Exam Materials
Course Introduction
Biomedical Laboratory Diagnostics is a comprehensive course that explores the fundamental principles, methodologies, and technologies used in laboratory diagnostics within the biomedical sciences. Students will gain an understanding of diagnostic testing processes, including specimen collection, preparation, and analysis, as well as the interpretation of laboratory results in the context of disease diagnosis and patient care. The course covers key areas such as clinical chemistry, hematology, immunology, microbiology, and molecular diagnostics. Emphasis is placed on quality assurance, laboratory safety, ethical considerations, and the integration of laboratory data in healthcare decision-making.
Recommended Textbook
Clinical Immunology and Serology A Laboratory Perspective 4th Edition by Christine Dorresteyn
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25 Chapters
784 Verified Questions
784 Flashcards
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Chapter 1: Introduction to Immunity and the Immune System
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Sample Questions
Q1) T cells mature in the:
A) bone marrow.
B) thymus.
C) lymph nodes.
D) spleen.
Answer: B
Q2) Which of the following is a characteristic of natural killer cells?
A) They mature in the thymus.
B) They are smaller than B and T cells.
C) They are a type of lymphocyte.
D) They are part of the adaptive immune system.
Answer: C
Q3) The process by which leukocytes are attracted to a specific area by chemical messengers is called:
A) diapedesis.
B) degranulation.
C) chemotaxis.
D) opsonization.
Answer: C
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Chapter 2: Nature of Antigens and the Major
Histocompatibility
Complex
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Q1) The term "human leukocyte antigen" is synonymous with: A) allele.
B) haplotype.
C) major histocompatibility complex.
D) chromosome.
Answer: C
Q2) Each class II MHC molecule has specificity for:
A) any endogenous peptide.
B) related peptides that share a similar peptide sequence.
C) one very specific peptide sequence.
D) native, conformational epitopes.
Answer: B
Q3) Which of the following is likely to be the most immunogenic?
A) A lipid with a molecular weight of 50,000 Da
B) A polysaccharide with a molecular weight of 40,000 Da
C) A protein with a molecular weight of 45,000 Da
D) A nucleic acid with a molecular weight of 60,000 Da
Answer: C
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Chapter 3: Innate Immunity
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Sample Questions
Q1) Patients with chronic granulomatous disease have neutrophils that cannot kill bacteria because they:
A) cannot phagocytize bacteria.
B) do not have granules containing antibacterial enzymes.
C) cannot produce superoxide.
D) cannot migrate to the site of infection.
Answer: C
Q2) For diapedesis to occur:
A) CD16 receptors must be bound.
B) microbes must be phagocytized.
C) endothelial cells must contract.
D) NADPH must be activated.
Answer: C
Q3) What is the major function of C-reactive protein?
A) Opsonization
B) Binding hemoglobin
C) Causing vasodilation
D) Promoting clot formation
Answer: A
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Page 5
Chapter 4: Adaptive Immunity
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Sample Questions
Q1) A T cell that is rarely found in secondary lymphoid organs and recognizes a limited number of native epitopes is known as:
A) a helper T cell.
B) a gamma-delta T cell.
C) a cytotoxic T cell.
D) an alpha-beta T cell.
Q2) The difference in kinetics between a primary and secondary immune response is caused by the presence of:
A) memory cells in the secondary response.
B) suppressor cells in the primary response.
C) macrophages in the secondary response.
D) T cells in the primary response.
Q3) Cytotoxic T cells are the primary immune response against which type of pathogen?
A) Viruses
B) Parasites
C) Bacteria
D) Fungi
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Chapter 5: Antibody Structure and Function
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Sample Questions
Q1) Which class makes up 70% to 80% of total serum immunoglobulins?
A) IgA
B) IgG
C) IgM
D) IgE
Q2) Identify the true statement about the anamnestic response versus the primary response.
A) The primary response has a long lag phase; the anamnestic response has a short lag phase.
B) The primary response has a short lag phase; the anamnestic response has a long lag phase.
C) the primary response involves a rapid increase in antibody titer, whereas the anamnestic response involves a rapid decrease in antibody titer.
D) The primary response involves predominantly an increase in IgG antibodies, whereas the anamnestic response involves predominantly an increase in IgM antibodies.
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Chapter 6: Cytokines
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Sample Questions
Q1) A person steps on a rusty nail,which punctures her skin and activates resident macrophages to secrete IL-1 beta.The fever that develops is an example of what type of cytokine signaling?
A) Autocrine
B) Paracrine
C) Endocrine
D) Kallikrein
Q2) Which of the following would be an effective therapy for rheumatoid arthritis?
A) TNF
B) IL-6
C) Antibodies against TNF receptors
D) Antibodies against IL-2
Q3) Identify the main action of IL-6.
A) Stimulates red blood cell production
B) Stimulates synthesis of acute-phase proteins
C) Inhibits antigen presentation by macrophages
D) Decreases activation of T and B cells
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8
Chapter 7: Complement System
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Sample Questions
Q1) Which of the following can activate the alternative complement pathway?
A) IgG
B) mannose-binding lectin
C) C3b
D) C1q
Q2) Kidney glomeruli can become obstructed with immune complexes as a result of:
A) properdin deficiency.
B) inadequate C3b-mediated opsonization.
C) membrane attack complex formation.
D) autoantibodies that bind C3bBb.
Q3) In the alternate pathway,factor B must bind to which of the following to initiate the cascade?
A) Factor I
B) C3b
C) C4b
D) Properdin
Q4) What is cleaved by C3bBb?
A) C3
B) C5
C) C6
Page 9
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Chapter 8: Safety and Quality Management
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Sample Questions
Q1) Where should you dispose of blood-soaked gauze pads?
A) Regular garbage
B) Sharps container
C) Red biohazard bag
D) Laundry bag
Q2) What does the acronym PASS stand for?
A) Pull, aim, squeeze, sweep
B) Pass, activate, sweep, scram
C) Pull, alarm, squeeze, sweep
D) Pass, activate, scram, scream
Q3) A coworker says she has an allergy to latex.As her supervisor,what should you advise her to do?
A) Wear latex gloves but wash her hands often to stop the allergy.
B) Wear gloves made of an alternative material.
C) Do not wear gloves.
D) Wash the latex gloves before using.
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Chapter 9: Principles of Serological Testing
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Sample Questions
Q1) The probability that a person with a positive screening test actually has the disease screened for is called:
A) sensitivity.
B) specificity.
C) positive predictive value.
D) negative predictive value.
Q2) If 0.9 mL of saline is added to 0.1 mL of serum,what does the 0.9 mL represent?
A) The final dilution
B) The diluent
C) The solute
D) The total solution
Q3) If you want to make 4 mL of a 1:20 dilution,how much serum would be needed?
A) 0.2 mL
B) 2 mL
C) 0.5 mL
D) 1 mL
Q4) An antibody titer is defined as the reciprocal of the:
A) last serial dilution tube in which a positive reaction is still visible.
B) first serial dilution tube in which a negative reaction is achieved.
C) diluent divided by the solvent.
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Chapter 10: Precipitation and Agglutination Reactions
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Sample Questions
Q1) The production of insoluble complexes that absorb or scatter light but are too small to see directly is called:
A) precipitation.
B) agglutination.
C) equivalence.
D) sensitization.
Q2) The measurement of light scattered at an angle by the antigen-antibody complexes in a solution is called:
A) turbidimetry.
B) nephelometry.
C) agglutination.
D) equivalency.
Q3) Agglutination reactions run at room temperature are appropriate for antigen-antibody reactions involving:
A) IgA.
B) IgE.
C) IgG.
D) IgM.
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12
Chapter 11: Labeled Immunoassays
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Sample Questions
Q1) Rheumatoid factor can cause false-positive results in which type of assay?
A) Homogeneous competitive
B) Heterogeneous competitive
C) Homogeneous noncompetitive
D) Heterogeneous noncompetitive
Q2) Which of the following best describes homogeneous assays?
A) A washing step is not necessary.
B) The concentration of patient antigen is always directly proportional to the label detected.
C) The reagent antibody has an enzyme tag.
D) Labeled and unlabeled analyte are present in equal amounts.
Q3) The standard method for detecting antinuclear antibodies (in certain autoimmune diseases)is:
A) direct immunofluorescence.
B) indirect immunofluorescence.
C) fluorescence polarization.
D) autofluorescence.
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13
Chapter 12: Molecular Diagnostic Techniques
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Sample Questions
Q1) Light is generated when nucleotides are added to a growing strand of DNA in the process of:
A) pyrosequencing.
B) ligase chain reaction.
C) strand displacement amplification.
D) branched DNA amplification.
Q2) What process confers specificity in molecular biology methods?
A) Amplification
B) Polymorphism
C) Strand cleavage
D) Hybridization
Q3) The common characteristic of transcription-mediated amplification and reverse-transcriptase polymerase chain reaction is that both:
A) are isothermal processes.
B) start with an RNA target.
C) use DNA polymerase.
D) generate RNA as the primary product.
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14
Chapter 13: Flow Cytometry and Laboratory Automation
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Sample Questions
Q1) The reference interval is determined by:
A) using a standardized reagent to establish the highest and lowest concentrations that can be measured by an instrument or test system.
B) measuring an analyte in samples from a large number of healthy people, using the same instrument or test system.
C) the period of time between the acquisition and testing of a sample.
D) the difference in concentration between the highest and lowest standards used in the standard curve.
Q2) What is a disadvantage of automated testing in a clinical immunology laboratory?
A) Decreases potential for manual errors
B) Increases dependence on a single machine
C) Cannot be used within the preanalytical stage of testing
D) Cannot perform combined chemistry and immunoassay testing on a single platform
Q3) How close a measured value is to the actual (true)value is called:
A) accuracy.
B) precision.
C) analytic sensitivity.
D) analytic specificity.
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15
Chapter 14: Hypersensitivity
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Sample Questions
Q1) A 5-year-old girl was rushed to the emergency department because she was having trouble breathing.She had been playing at the park when she fell down and her face and neck started to swell up.One of her friends thought that the girl might have been stung by a bee because a bee was flying around them,and shortly before the girl fell to the ground,she had screamed.The girl had a large red bump on her cheek.This girl likely has:
A) Bruton's hypogammaglobulinemia.
B) type I diabetes.
C) type I hypersensitivity.
D) type IV hypersensitivity.
Q2) Compared with percutaneous (prick)tests,intradermal skin tests:
A) are more sensitive.
B) require less antigen.
C) carry less risk.
D) are better for diagnosing food allergies.
Q3) Contact dermatitis can be characterized by:
A) formation of antigen-antibody complexes.
B) immediate sensitization of Th1 cells.
C) Langerhans cells acting as antigen-presenting cells.
D) decreased cytokine production.
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Page 16
Chapter 15: Autoimmunity
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Sample Questions
Q1) A 25-year-old female sees her physician because of swelling in the joints of her hands and generally feeling tired and rundown.A slide agglutination test for antibody directed against IgG is positive.What is the most likely cause of her symptoms?
A) Autoimmune hemolytic anemia
B) Rheumatoid arthritis
C) Mononucleosis
D) Syphilis
Q2) The fluorescent antinuclear antibody test for lupus is an example of which of the following?
A) Competitive immunoassay
B) Immunofixation
C) Indirect fluorescence testing
D) Direct fluorescence testing
Q3) Hashimoto's thyroiditis can best be differentiated from Graves disease on the basis of which of the following?
A) Decrease in thyroid hormone levels
B) Presence of thyroid peroxidase antibodies
C) Enlargement of the thyroid
D) Presence of lymphocytes in the thyroid
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Chapter 16: Transplantation Immunology
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Sample Questions
Q1) Suppose a mother and her child possess the following HLA haplotypes:?Mother: ?A28 B17 Cw4 Dw3?A30 B21 Cw2 Dw10?Child: ?A3 B8 Cw6 Dw7?A28 B17 Cw4 Dw3 Paternity testing was performed.Three potential fathers were HLA typed and found to contain the following haplotypes:?Father 1: ?A30 B21 Cw2 Dw10?A1 B2 Cw5 Dw9?Father 2: ?A3 B8 Cw6 Dw7?A8 B9 Cw1 Dw8?Father 3: ?A3 B8 Cw5 Dw4?A2 B1 Cw6 Dw7??Which of the following statements is true?
A) The true father may be Father 1 only.
B) The true father may be Father 2 only.
C) The true father may be Father 1 or Father 2.
D) The true father may be Father 2 or Father 3.
Q2) To determine a patient's HLA type using the complement-dependent cytotoxicity test,which of the following must be used?
A) Viable lymphocytes
B) Purified T cells
C) A single antiserum from a commercial source
D) Complement from patient serum
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18
Chapter 17: Tumor Immunology
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Sample Questions
Q1) Tumor-associated antigens are expressed only in tumor cells.
A)True
B)False
Q2) Carcinoembryonic antigen
A)Hepatocellular carcinoma
B)Ovarian cancer
C)Colorectal, breast, or lung cancer
D)Breast cancer only
E)Pancreatic and gastrointestinal cancers
Q3) HER-2
A)Hepatocellular carcinoma
B)Ovarian cancer
C)Colorectal, breast, or lung cancer
D)Breast cancer only
E)Pancreatic and gastrointestinal cancers
Q4) A tumor that is classified as malignant is described as:
A) a disorganized mass that is not encapsulated and can invade nearby organs.
B) a slow-growing, organized mass of encapsulated cells.
C) usually confined to the skin.
D) an area of swelling that shows no abnormal growth of cells.
Page 19
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Chapter 18: Immunoproliferative Diseases
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Sample Questions
Q1) Which type of gene is required for cell growth and division but can cause malignant transformation when altered?
A) Tumor suppressor gene
B) Proto-oncogene
C) Anti-tumor gene
D) Immunoglobulin gene
Q2) Which of the following findings is a diagnostic criterion for monoclonal gammopathy of undetermined significance?
A) Serum monoclonal protein greater than 3 g/dL
B) Plasma cell count lower than 10% of total cells in bone marrow
C) Increased calcium in the blood
D) Presence of CRAB features
Q3) Which cytogenetic abnormality is associated with an excellent prognosis in children with B-cell acute lymphoblastic leukemia (ALL)?
A) t(12:21)(p13;q22)
B) t(14:18)(p13;q22)
C) t(9;22)
D) Hypodiploidy
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Chapter 19: Immunodeficiency Diseases
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Sample Questions
Q1) Defects in oxidative burst activity can be detected using flow cytometry by labeling patient neutrophils with:
A) nitroblue tetrazolium.
B) purified protein derivative.
C) dihydrorhodamine.
D) phytohemagglutinin.
Q2) A male baby who has suffered from persistent Candida fungal infections and several bouts of pneumonia before the age of 6 months is found to have some developmental problems as well as low-set ears.Laboratory testing reveals an absence of T cells.What is the most likely diagnosis?
A) Selective IgA deficiency
B) Common variable immunodeficiency
C) Waldenström macroglobulinemia
D) DiGeorge syndrome
Q3) Which is true of selective IgA deficiency?
A) It is invariably fatal.
B) It is very rare.
C) It mainly occurs in older adults.
D) Patients may develop an anti-IgA antibody.
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Page 21
Chapter 20: Serological and Molecular Detection of Bacterial Infections
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Sample Questions
Q1) The pathogenesis of poststreptococcal glomerulonephritis involves:
A) deposition of immune complexes in the kidneys.
B) destruction of glomeruli by streptolysin O.
C) bacterial-induced dehydration.
D) invasion of the kidneys by Streptococcus pyogenes.
Q2) Identify the true statement about exotoxins.
A) They are structural proteins on the exterior surface of bacteria.
B) They nonspecifically activate host complement and coagulation cascades.
C) They bind to specific receptors on host cells.
D) They promote bacterial adhesion.
Q3) Complement helps in the defense against bacterial invasion by:
A) promoting phagocytosis.
B) neutralizing bacterial toxins.
C) preventing bacteria from penetrating the skin.
D) fusing lysosomal granules to bacterial cell walls.
Q4) Select the true statement about Helicobacter pylori.
A) It is a gram-positive coccus that causes skin infections.
B) It is a gram-negative spiral bacterium that causes ulcers.
C) It lacks a cell wall and produces a lot of acid.
D) It can be detected by testing for cold agglutinins.
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Chapter 21: Spirochete Diseases
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Sample Questions
Q1) Select the characteristic associated with Borrelia miyamotoi.
A) Usually causes a ring-shaped rash
B) Does not induce antibodies in patients that cross-react in Lyme disease assays
C) Causes relapsing fevers
D) Can be easily cultured in diagnostic procedures
Q2) Tests for specific treponemal antibody include which of the following?
A) VDRL
B) RPR
C) FTA-ABS
D) All of the above
Q3) Using the reverse algorithm method for syphilis diagnosis,a positive initial test and a negative follow-up test could be interpreted as:
A) a false negative in the treponemal test.
B) a false positive in the nontreponemal test.
C) past syphilis infection with subsequent decline in nontreponemal antibody titers.
D) current syphilis, likely in the secondary stage.
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Chapter 22: Serological and Molecular Diagnosis of Parasitic
and Fungal
Infections
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Q1) Which statement best describes antigenic variation of a parasite?
A) Parasites can change their antigens or create novel antigens.
B) Parasites do not have any surface antigens.
C) Parasites are ingested by macrophages, and antigens are denatured.
D) Parasites have similar host antigens.
Q2) A patient presents with a fungal infection.Which components of the immune system are activated early in the course of the patient's infection?
A) Macrophages and dendritic cells
B) Natural killer cells and antibodies
C) Polysaccharides and chitins
D) T cells and B cells
Q3) Serology assays are useful in the diagnosis of Aspergillus infections from bronchial lavage samples in immunocompromised patients.
A)True
B)False
Q4) To correctly determine an infection with toxoplasmosis within the last 12 months,both IgG and IgM should be negative.
A)True
B)False
Page 24
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Chapter 23: Serology and Molecular Detection of Viral Infections
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Q1) A newborn infant tests positive for anti-HBc IgG.This result is evidence that:
A) the infant is infected with hepatitis B
B) the mother was infected with hepatitis B.
C) both mother and infant are infected with hepatitis B.
D) Both mother and infant are immune to hepatitis B.
Q2) Infection by which of the following viruses is not preventable by routine immunization?
A) Cytomegalovirus
B) Rubella virus
C) Rubeola virus
D) Varicella-zoster virus
Q3) A 14-year-old boy presents to the physician complaining of sore throat,fatigue,and fever for the past week.A monotest is performed and is reported as positive.It is likely that this boy has:
A) infectious mononucleosis.
B) streptococcal pharyngitis.
C) acute glomerulonephritis.
D) a common cold.
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Chapter 24: Laboratory Diagnosis of HIV Infection
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Q1) p66
A) Component of reverse transcriptase enzyme
B) Transmembrane protein
C) Envelope protein that binds to CD4 on T cells
D) Core coat for nucleic acids
Q2) In the Western blot test for HIV antibody,a positive test result is indicated by the bands p24 and p55.
A)True
B)False
Q3) Which HIV group is responsible for a majority of the HIV infections worldwide?
A) Group M
B) Group O
C) Group N
D) Group P
Q4) When HIV replicates,the DNA in the viral genome is transcribed into RNA.
A)True
B)False
Q5) The Southern blot test is the specific confirmatory test for HIV infection.
A)True
B)False
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Chapter 25: Immunization and Vaccines
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Q1) Human immune serum globulin is made from the pooled serum of thousands of donors.
A)True
B)False
Q2) Hematopoietic stem cell transplantation is an example of adoptive immunity.
A)True
B)False
Q3) Inactivated vaccine
A) Vaccine produced by incorporating a gene from a pathogenic microorganism into the genome of nonpathogenic bacteria, yeast, or other cells
B) Vaccine in which intact, killed viruses or bacteria retain antigenic properties to induce a predominantly humoral immune response
C) The use of bacteria or viruses that have been weakened
D) Chemically inactivated bacterial exotoxins that induce the production of antibodies
Q4) An effective method of acquiring immunity is through the method of community immunity.
A)True
B)False
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