Clinical Immunology Test
Bank
Course Introduction
Clinical Immunology examines the mechanisms by which the immune system protects the body from infectious diseases, malignancies, and autoimmune processes, with a focus on its clinical implications. The course covers the cellular and molecular components of the immune response, immunopathology, diagnostic immunology, hypersensitivity reactions, primary and secondary immunodeficiencies, and transplantation immunology. Students also explore current approaches to immunotherapy, vaccines, and the management of immune-mediated diseases, integrating case studies and laboratory analysis to bridge foundational theory with patient-centered clinical practice.
Recommended Textbook
Immunology Serology in Laboratory Medicine 5th Edition by Mary Louise Turgeon
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33 Chapters
851 Verified Questions
851 Flashcards
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Chapter 1: An Overview of Immunology
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27 Verified Questions
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Sample Questions
Q1) T lymphocytes respond to:
A) antigens presented on the surface of an antigen-presenting cell.
B) antigens on microorganisms or other living cells.
C) native antigenic determinants of appropriate fit.
D) antigens floating in body fluids.
Answer: A
Q2) Cell-mediated immunity is moderated by:
A) B lymphocytes.
B) T lymphocytes.
C) monocytes-macrophages.
D) both b and c
Answer: D
Q3) Characteristics of clonal selection include:
A) antigen binding to a unique antigen receptor site.
B) activation of antigen-bound lymphocytes.
C) proliferation of antigen-bound lymphocytes.
D) all of the above.
Answer: D
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3
Chapter 2: Antigens and Antibodies
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Sample Questions
Q1) Cross-reactivity
A)Noncovalent combination of antigen with its respective specific antibody
B)Functional combining strength of an antibody with its antigen
C)Initial force of attraction that exists between a single Fab site on an antibody molecule and a single epitope on the corresponding antigen
D)A portion of antibodies directed against one type of antigen will also react with another type of antigen.
E)Ability of a particular antibody to combine with one antigen instead of another
Answer: D
Q2) A secondary antibody response can also be called a(n):
A) anamnestic response.
B) response with greater concentrations of IgG.
C) memory response.
D) all of the above.
Answer: D
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4
Chapter 3: Cells and Cellular Activities of the Immune
System: Granulocytes and Mononuclear Cells
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Sample Questions
Q1) Sepsis
A)Characterized by local redness,swelling,and pain
B)An infection-induced systemic condition
Answer: B
Q2) Specific granule deficiency
A)Disorder of oxidative metabolism
B)Impaired chemotaxis and delayed killing of ingested bacteria
C)Presents as a leukocyte adhesion deficiency
D)Mild to moderate defect in bacterial killing
E)Recurrent,severe bacterial infections
Answer: E
Q3) Eosinophil
A)Principal leukocyte associated with phagocytosis
B)High concentrations of heparin and histamine
C)Homeostatic regulator of inflammation
Answer: C
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Chapter 4: Cells and Cellular Activities of the Immune
System: Lymphocytes and Plasma Cells
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Sample Questions
Q1) The T cell receptor (TCR)recognizes an antigen:
A) when it is coated with antibody.
B) when it is coated with complement.
C) as a peptide bonded to an MHC class II molecule on the surface of an antigen-presenting cell.
D) as a free-floating antigen in the peripheral blood or lymphatic circulation.
Q2) Cytotoxic T lymphocytes,or T cytotoxic (Tc)cells
A)Effector cells that can directly destroy virally infected target cells
B)Downregulate the actions of other T and B cells
C)Relatively high avidity for self-antigens
Q3) B lymphocytes
A)Lead to antibody production
B)Destroy target cells through an extracellular nonphagocytic mechanism (cytotoxic reaction)
C)Kill target cells sensitized with antibody
Q4) Surface markers on lymphocytes can be used to:
A) identify and count CD4+ and CD8+ cells.
B) classify leukemic cells.
C) monitor patients on immunotherapy.
D) all of the above.
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Chapter 5: Soluble Mediators of the Immune System
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Sample Questions
Q1) The complement cascade reaches its full amplitude at the _________ stage.
A) C1
B) C3
C) C4
D) factor H.
Q2) The classic complement pathway is activated by:
A) platelet factor 2.
B) C3B.
C) factor B.
D) factor D.
Q3) In innate immunity,cytokines stimulate the proliferation and differentiation of antigen-stimulated lymphocytes and activate specialized effector cells.
A)True
B)False
Q4) The physiologic or cellular consequences of complement activation can include:
A) production of inflammatory mediators.
B) cytolysis or hemolysis.
C) opsonization.
D) all of the above.
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Chapter 6: Safety in the Immunology-Serology Laboratory
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Sample Questions
Q1) Pipetting by mouth is forbidden in all circumstances.
A)True
B)False
Q2) In regard to handwashing in the medical laboratory environment,hands should be washed immediately after accidental skin contact with blood.
A)True
B)False
Q3) Gloves should be worn when performing fingersticks and heelsticks on infants and children.
A)True
B)False
Q4) In regard to handwashing in the medical laboratory environment,hands should be washed after completing laboratory work.
A)True
B)False
Q5) Food and drinks should not be consumed in work areas.
A)True
B)False
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Chapter 7: Quality Assurance and Quality Control
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Sample Questions
Q1) Expected or normal (reference)values
A)Quality control
B)Sources of error
C)Principle and purpose of the test
D)Procedural protocol
Q2) A control specimen should be:
A) carried through the entire test procedure.
B) treated in exactly the same way as any patient specimen.
C) assayed at least once a week.
D) both a and b
Q3) Nonanalytical factors in quality assessment include:
A) qualified personnel.
B) established laboratory policies.
C) quality control charts.
D) both a and b
Q4) If the control value in a determination is out of the acceptable range,faulty instrument or equipment may be the factor responsible.
A)True
B)False
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Chapter 8: Basic Serologic Laboratory Techniques
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Sample Questions
Q1) A central concept of serologic testing is:
A) antigen-antibody interaction.
B) determination of antibody composition.
C) determination of antigen titer.
D) rise in antibody titer.
Q2) Serum for the detection of antibodies should be drawn during the:
A) acute phase of illness only.
B) acute and convalescent phases of illness.
C) convalescent phase of illness only.
D) acute and convalescent phases,as well as 6 months after an illness.
Q3) Graduated pipette
A)Delivers the amount of liquid contained between two calibration marks on the pipette.
B)The letters TD (to deliver)appear on the pipette.
Q4) A meniscus is the:
A) curvature in the top surface of a liquid.
B) zero mark on a pipette.
C) last marking on a serologic pipette.
D) flat line of liquid in a pipette.
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Page 10
Chapter 9: Point-Of-Care Testing
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Sample Questions
Q1) Written policies and procedures must be available to all laboratory personnel for patient preparation and for specimen collection and preservation.
A)True
B)False
Q2) For diagnostic purposes,human chorionic gonadotropin (hCG)test results should always be used with other methods and in the context of the patient's clinical information (e.g. ,medical history,symptoms,results of other tests,clinical impression).
A)True
B)False
Q3) Moderately complex tests
A)More complex than waived tests but usually automated
B)Usually nonautomated or complicated tests requiring considerable judgment
C)Simple procedures
D)Slide examinations
Q4) A major advantage of point-of-care testing (POCT)is:
A) faster turnaround time.
B) lower cost.
C) no need for quality control monitoring.
D) both a and c
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Chapter 10: Agglutination Methods
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Sample Questions
Q1) The quality of agglutination or precipitation test results depends on:
A) length of incubation with the serum containing antibody.
B) amount of antigen conjugated to the carrier.
C) pH.
D) all of the above.
Q2) Flocculation
A)Uses antibodies bound to a particle to enhance the visibility of the reaction
B)Based on the interaction of soluble antigen with antibody
C)Detects antibodies with erythrocyte antigens
Q3) The strength of an agglutination reaction can be enhanced by:
A) centrifugation.
B) use of albumin.
C) use of low ionic strength saline.
D) all of the above.
Q4) All the following procedures are typically performed by latex agglutination or latex agglutination inhibition assays except:
A) C-reactive protein (CRP).
B) rheumatoid factors (IgG).
C) pregnancy testing.
D) RPR for syphilis.
Page 12
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Chapter 11: Electrophoresis Techniques
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Sample Questions
Q1) Separation of proteins by electrophoresis is based on:
A) rate of migration of individual components in an electrical field.
B) size of various molecules as they diffuse on cellulose acetate.
C) the type of support medium such as cellulose acetate.
D) all of the above.
Q2) The prozone phenomenon should be suspected if:
A) the preciptin arc appears to run into a trough.
B) a light chain appears fuzzy when a heavy chain is increased.
C) an arc appears to be incomplete.
D) all of the above.
Q3) Immunoelectrophoreis (IEP)is easier to interpret than immunofixation electrophoresis (IFE).
A)True
B)False
Q4) Immunoelectrophoresis (IEP)can divide the proteins of normal serum into _______________ distinct precipitation bands.
A) 5 to 10
B) 15 to 20
C) 25 to 40
D) 45 to 100
Page 13
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Chapter 12: Labeling Techniques in Immunoassay
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Sample Questions
Q1) Chemiluminescent enzyme labels often used in indirect procedures are:
A) alkaline phosphatase.
B) horseradish peroxidase.
C) beta-galactosidase.
D) all of the above.
Q2) In a changing clinical environment,the indirect immunofluorescent assay (IFA)has been replaced with the enzyme immunoassay (EIA).A disadvantage of this trade-off to EIA is:
A) lower cost.
B) that it is slower in producing results.
C) that it is more technically challenging and requires more training and experience.
D) that it is problematic for patients with less than a 1:160 antinuclear antibody (ANA)titer.
Q3) Capture EIA
A)The amount of color that develops in the reaction is inversely proportional to the amount of antibody.
B)Antibody specific for immunoglobulin M (IgM)or IgG is attached to a solid-phase surface.
C)A specific antigen is attached to a solid-phase surface.
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Chapter 13: Automated Procedures
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Sample Questions
Q1) In nephelometry measurement,a __________________method is used.
A) variable-time
B) fixed-time
C) fluorescent-tagging
D) competitive immunoassay
Q2) Validation of results
A)Preanalytical
B)Analytical
C)Postanalytical
Q3) In nephelometry measurement,if antigen overwhelms the quantity of antibody,the measured signal:
A) increases.
B) decreases.
C) remains the same.
D) fluctuates between high and low.
Q4) Laser light is concentrated.
A)True
B)False
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Page 15
Chapter 14: Molecular Techniques
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Sample Questions
Q1) The gold standard of molecular testing is:
A) DNA sequencing.
B) FISH.
C) reverse transcriptase.
D) nephelometry.
Q2) Northern blot
A)RNA
B)DNA
C)Use of labeled antibodies specific for the protein of interest
Q3) The PCR technique can be modified to study ribonucleic acid (RNA)as well as deoxyribonucleic acid (DNA).
A)True
B)False
Q4) The final number of molecules produced in 30 cycles of the PCR process is:
A) 22
B) 210
C) 220
D) 230
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Page 16
Chapter 15: The Immune Response in Infectious Diseases
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Sample Questions
Q1) Fungal infections can be opportunistic infections in patients who:
A) have AIDS.
B) are immunosuppressed with medications.
C) are transplant patients receiving antirejection medicines.
D) all of the above.
Q2) All the following are fungal diseases except:
A) histoplasmosis.
B) aspergillosis.
C) toxoplasmosis.
D) coccidioidomycosis.
Q3) Factors that can influence exposure to,or actual development of,an infectious disease include all the following factors except the:
A) immune status of an individual.
B) pathogenicity of the microbial agent.
C) season of the year.
D) appropriate portal of entry.
Q4) Primary infection with the virus results in the clinical manifestations of
A)Shingles
B)Chickenpox
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Chapter 16: A Primer on Vaccines
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Sample Questions
Q1) The earliest host response to vaccination is a(n):
A) innate immune response.
B) memory response.
C) anamnestic response.
D) both a and b
Q2) Influenza vaccine
A)Protection against bioterrorism
B)Protection against cervical cancer
C)Not available for preventing congenital infection
D)DNA-based vaccine
E)Annual vaccination required
Q3) The Center for Biologics Evaluation and Research (CBER)regulates:
A) laboratory safety.
B) vaccine products.
C) personnel qualifications.
D) research grants.
Q4) Preventive vaccine
A)Given to HIV-negative individuals
B)For HIV-positive patients to improve their immune system
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Chapter 17: Streptococcal Infections
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Sample Questions
Q1) Most patients who have Streptococcus pyogenes infection begin to demonstrate a rise in antibody titer in:
A) 2 days.
B) 7 days.
C) 14 days.
D) 30 days.
Q2) The case definition of STSS and necrotizing fasciitis includes:
A) serologic confirmation of group A streptococcal infection by a fourfold rise against SLO.
B) serologic confirmation of group A streptococcal infection by a fourfold rise against DNAse B.
C) severe red rash.
D) both a and b
Q3) Members of the S.pyogenes species are almost always _____-hemolytic.
A) alpha
B) beta
C) gamma
D) alpha or beta
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Chapter 18: Syphilis
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Sample Questions
Q1) The nontreponemal antibody produced by syphilis-infected patients can also be produced by patients with:
A) other infectious diseases.
B) leprosy,tuberculosis,leptospirosis,or malaria.
C) autoimmune disorders,drug addiction,or old age.
D) all of the above.
Q2) Before clinical or serologic manifestations,the incubation period for syphilis usually lasts:
A) 3 to 7 days.
B) 7 to 10 days.
C) about 3 weeks.
D) about 6 weeks.
Q3) If an RPR assay is negative but has a rough appearance,what is an appropriate follow-up step?
A) Report as a negative assay result.
B) Repeat the assay.
C) Repeat the assay with serial dilutions.
D) Request a new blood specimen for repeat testing.
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20
Chapter 19: Vector-Borne Diseases
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Sample Questions
Q1) Final stage
A)Packed elementary bodies (initial bodies)visible
B)Enter a leukocyte by phagocytosis and multiply rapidly
C)Morular,or mulberry,forms
Q2) B.afzelii
A)Associated with the chronic skin condition acrodermatitis chronica atrophicans (ACA)in Europe
B)United States
C)Associated with neurologic symptoms in Europe
Q3) Serologic assays for Lyme disease are:
A) highly specific in the early stages.
B) highly sensitive in the early stages.
C) insensitive during the first several weeks of infection.
D) insensitive during the first months of infection.
Q4) First stage
A)Packed elementary bodies (initial bodies)visible
B)Enter a leukocyte by phagocytosis and multiply rapidly
C)Morular,or mulberry,forms
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21
Chapter 20: Toxoplasmosis
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Sample Questions
Q1) Symptoms of acquired T.gondii infection can:
A) be mild.
B) resemble infectious mononucleosis.
C) cause a urinary tract infection.
D) both a and b
Q2) Congenital toxoplasmosis can result in:
A) central nervous system (CNS)malformation.
B) prenatal mortality.
C) congenital heart defects.
D) both a and b
Q3) IgM antibodies to T.gondii in an adult are an indication of:
A) current or recent infection.
B) chronic infection.
C) past infection.
D) antibody transmitted from another person.
Q4) The best evidence of toxoplasmosis infection is a significant change in:
A) two appropriately timed specimens.
B) acute and convalescent specimens.
C) two appropriate specimens analyzed at the same time in the laboratory.
D) all of the above.
22
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Chapter 21: Cytomegalovirus
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Sample Questions
Q1) Primary infection
A)IgG,but IgM response unknown
B)Specific IgM antibody response
C)IgG (no detectable IgM)
Q2) The great majority of infections in allograft recipients:
A) are transmitted by a donated organ.
B) arise from the reactivation of the recipient's latent virus.
C) are transmitted through transfusion of packed red blood cells.
D) both a and b
Q3) Acquired CMV infection is usually asymptomatic and can persist in the host as a chronic or latent infection.
A)True
B)False
Q4) Cytomegalovirus (CMV)is related to:
A) Epstein-Barr virus (EBV).
B) herpes simplex 1.
C) herpes simplex 2.
D) all of the above.
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23
Chapter 22: Infectious Mononucleosis
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Sample Questions
Q1) Immunoglobulin M (IgM)heterophil antibody is characterized by absorption by guinea pig kidney cells.
A)True
B)False
Q2) EBV is transmitted primarily by:
A) close contact with infectious oropharyngeal secretions.
B) blood transfusion.
C) transplacental exposure.
D) transplanted organs or tissues.
Q3) A blood transfusion from an immune donor to a nonimmune recipient may produce:
A) no effect.
B) a primary infection.
C) a secondary infection.
D) a reactivated infection.
Q4) Davidsohn differential test
A)Distinguishes between heterophil antibodies;uses beef erythrocytes,guinea pig kidney cells,and sheep erythrocytes
B)Detects heterophil antibodies and uses horse erythrocytes
C)Detects heterophil antibodies and uses sheep erythrocytes
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Chapter 23: Viral Hepatitis
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Sample Questions
Q1) A chronic carrier state (persistent infection)and chronic hepatitis (chronic liver disease)_______ occur as long-term sequelae of hepatitis A.
A) do
B) do not
Q2) Hepatitis B virus
A)Complex DNA virus
B)Small,RNA-containing picornavirus
C)Small,enveloped,single-stranded RNA virus
Q3) Hepatitis A virus
A)Complex DNA virus
B)Small,RNA-containing picornavirus
C)Small,enveloped,single-stranded RNA virus
Q4) Primary hepatitis viruses account for approximately ______% of cases of hepatitis.
A) 10
B) 25
C) 50
D) 95
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25
Chapter 24: Rubella and Rubeola Infections
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Sample Questions
Q1) No rubella infection outbreaks have occurred in the United States in the recent past.
A)True
B)False
Q2) Production of IgG antibody to rubella virus is not associated with the appearance of clinical signs and symptoms.
A)True
B)False
Q3) Methods for detecting rubella include all the following except:
A) hemagglutination inhibition.
B) an enzyme immunoassay (EIA).
C) a fluorescent immunoassay (FIA).
D) viral culture.
Q4) Immunity to rubella results from:
A) contracting a rubella infection.
B) vaccination against rubella.
C) exposure to other childhood infectious diseases.
D) both a and b
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Chapter 25: Acquired Immunodeficiency Syndrome
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Sample Questions
Q1) A positive Western blot test (WB)for HIV infection is indicated by the presence of __________ bands.
A)p24
B)gp60 and gp160
C)p24 and p31
D)p24 and gp41
Q2) In some countries (e.g. ,sub-Saharan Africa,Thailand,India)(1)_________ of HIV-1 infections are acquired through heterosexual transmission in contrast to (2)_______ in the United States and Western Europe.
A)less than 10%
B)25%
C)50%
D)more than 90%
Q3) In HIV infections,a window period of seronegativity extends from the time of initial infection up to:
A) 2 weeks.
B) 2 to 6 weeks or longer.
C) 6 to 12 weeks or longer.
D) 4 to 8 months or longer.
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Chapter 26: Hypersensitivity Reactions
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Sample Questions
Q1) Type I hypersensitivity reactions are characterized by:
A) activation of complement.
B) antigen cross-links with IgE on mast cells.
C) being potentially fatal.
D) both b and c
Q2) Asthma is an example of a _____________ hypersensitivity reaction.
A) type I
B) type II
C) type III
D) type IV
Q3) Immediate hypersensitivity
A)Cell-mediated
B)Antibody-mediated
C)Dependent on the host's response to a subsequent exposure of antigen
D)Not mediated by antigen-antibody interaction
Q4) Immune complex reactions can:
A) suppress or augment the immune response.
B) inhibit tumor cell destruction.
C) be deposited in blood vessel walls,glomerular membranes,and other sites.
D) all of the above.
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Chapter 27: Immunoproliferative Disorders
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Sample Questions
Q1) Cryoglobulins are proteins that precipitate at:
A) -18° C.
B) -4° C.
C) 0° C.
D) 4° C.
Q2) Multiple myeloma is the most common form of dysproteinemia.It accounts for (1)_______% of all types of malignant diseases and (2)_______% of hematologic malignancies.
A)1
B)10
C)15
D)25
Q3) Bence Jones proteinuria is often associated with:
A) intrarenal obstruction.
B) direct tubular-cell injury.
C) renal failure.
D) all of the above.
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Chapter 28: Autoimmune Disorders
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Sample Questions
Q1) Tendency to develop cancer in the organ.
A)Organ-specific
B)Organ- nonspecific
Q2) Anti-Scl antibody
A)Measures antibody to nuclear antigens
B)Produces a characteristic granular cytoplasmic staining pattern to cytoplasmic constituents of granulocytes
C)An antibody to a basic nonhistone nuclear protein
D)Found in about 80% of patients with pernicious anemia
Q3) An individual may develop an autoimmune response to:
A) antigens that do not normally circulate in the blood.
B) altered antigens.
C) loss of immunoregulatory function by lymphocyte subsets.
D) all of the above.
Q4) The cause of insulin-dependent diabetes mellitus is:
A) immune destruction of B lymphocytes in pancreatic islets.
B) immune destruction of T lymphocytes in pancreatic islets.
C) anti-parietal cell antibody.
D) anti-islet cell antigen.
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Chapter 29: Systemic Lupus Erythematosus
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Sample Questions
Q1) One of the most potent inducers of abnormalities and clinical manifestations of SLE is:
A) hydralazine.
B) procainamide.
C) isoniazid.
D) both a and b
Q2) Serologic assessment of renal disease in systemic lupus erythematosus (SLE)includes:
A) cryoglobulin level assay.
B) serum electrophoresis.
C) serum creatinine level assay.
D) urinary protein excretion.
Q3) Peripheral or rim
A)4-6S RNP
B)Antibody to nucleolar RNA
C)Antibody to any extractable nuclear antigen devoid of DNA or histone
D)nDNA
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Chapter 30: Rheumatoid Arthritis
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Sample Questions
Q1) Indicate whether the following laboratory assays are highly specific or nonspecific for RA:
1)Cyclic citrullinated peptide (CCP)antibodies
2)Antibodies to anti-perinuclear factor (APF)
3)Antibodies to keratin (AKA)
4)Antinuclear antibodies (ANAs)
A) Highly specific for RA
B) Nonspecific for RA
Q2) Being rheumatoid factor (RF)-positive correlates with other organ system involvement (e.g. ,vasculitis,Felty's syndrome,Sjögren's syndrome).
A)True
B)False
Q3) Which of the following immunoglobulins or molecular components is used in rheumatoid factor (RF)rapid slide assays?
A) Fc portion of IgM
B) Fc portion of IgG
C) IgM
D) IgG
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Chapter 31: Solid Organ Transplantation
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) Immunosuppression is used for induction (intense immunosuppression in the initial days after transplantation).
A)True
B)False
Q2) Which of the following classes of MHC antigens is necessary for antigen recognition by CD4+ T lymphocytes?
A) class I
B) class II
C) both class I and class II
D) neither class I nor class II
Q3) Patients receiving total-body radiation or immunosuppressive therapy for disorders such as lymphoma and acute leukemia
A)High-risk patients
B)Intermediate-risk patients
C)Low-risk patients
Q4) Immunosuppression is used for the maintenance of the transplant.
A)True
B)False
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Chapter 32: Bone Marrow Transplantation
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28 Verified Questions
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Sample Questions
Q1) Hematopoietic stem cells are:
A) uncommitted progenitor cells.
B) immature erythrocytes.
C) CD 34+ cells.
D) large,granular lymphocytes.
Q2) PBSCs are obtained by:
A) phlebotomy.
B) apheresis.
C) leukapheresis.
D) both b and c
Q3) Toxicities and side effects associated with the infusion of cryopreserved products are mainly caused by:
A) DMSO preservative.
B) volume overload.
C) glycerol preservative.
D) both a and b
Q4) Allogeneic
A)Stem cells from identical twins
B)Marrow from a related or unrelated donor
C)Transplant of own cells
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Chapter 33: Tumor Immunology
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) Metastasis
A)Benign
B)Malignant
Q2) Act on the S,G2,or M phase of mitosis
A)Cell cycle active,phase-specific
B)Cell cycle active,phase-nonspecific
C)Non-cell cycle active
Q3) Tumor immunity has the following general feature-the immune system can be stimulated to kill tumor cells and rid the host of the tumor.
A)True
B)False
Q4) Tumor-associated antigens
A)Cell surface molecules coded for by tumorigenic viruses
B)Gene derepression responsible for the production of increased concentrations of these gene products
C)Chemically induced tumors
D)Caused by no known mechanism
Q5) Increase in number of cells that accumulate
A)Benign
B)Malignant
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