Clinical Laboratory Science
Final Exam Questions
Course Introduction
Clinical Laboratory Science is an interdisciplinary course that introduces students to the principles and techniques involved in the analysis of biological specimens for the diagnosis, treatment, and prevention of diseases. The course covers essential topics such as clinical chemistry, hematology, microbiology, immunology, and molecular diagnostics, emphasizing quality assurance, safety protocols, and ethical considerations in the laboratory setting. Through lectures, hands-on laboratory exercises, and case studies, students develop proficiency in the operation of laboratory equipment, specimen handling, data interpretation, and the application of laboratory findings to patient care, preparing them for roles in medical laboratories and healthcare teams.
Recommended Textbook
Clinical Immunology and Serology A Laboratory Perspective 4th Edition by Christine Dorresteyn
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Chapter 1: Introduction to Immunity and the Immune System
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Sample Questions
Q1) Which best describes lymph nodes?
A) They line the interior of small blood vessels.
B) They are concentrated where appendages join the thorax of the body.
C) They are approximately 12 cm in size.
D) They are considered primary or central lymphoid organs.
Answer: B
Q2) "Cluster of differentiation" refers to:
A) a category of cell surface proteins used to identify cell types.
B) aggregates of differentiating stem cells.
C) groups of antigens that identify a cell as foreign.
D) the cells that congregate in germinal centers.
Answer: A
Q3) Which of the following are components of both innate and adaptive immune responses?
A) Immunoglobulins
B) T helper cells
C) Macrophages
D) B cells.
Answer: C
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Chapter 2: Nature of Antigens and the Major
Histocompatibility Complex
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Q1) Which of the following is a low-molecular-weight molecule that has one binding site for an antibody?
A) Antigen
B) Hapten
C) Immunogen
D) Adjuvant
Answer: B
Q2) The inheritance of certain MHC antigens can result in which of the following?
A) Increased resistance to certain infectious organisms
B) Predisposition to particular autoimmune diseases
C) Diminished immune responses to particular antigens
D) All of the above
Answer: D
Q3) Which of the following molecules is the best immunogen?
A) Protein
B) Polysaccharide
C) Nucleic acid
D) Lipid
Answer: A
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Chapter 3: Innate Immunity
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Sample Questions
Q1) Macrophages use all of the following to kill bacteria EXCEPT:
A) hydrogen peroxide.
B) perforin.
C) hydroxyl radical.
D) lysozyme.
Answer: B
Q2) Toll-like receptors and C-type lectin receptors are examples of:
A) pathogen-recognition receptors.
B) antigen receptors.
C) Fc receptors.
D) killer inhibitory receptors.
Answer: A
Q3) The killing mechanism of natural killer cells is regulated by:
A) inhibitory receptors.
B)activating receptors.
C)both inhibitory and activating receptors.
D)none of the above.
Answer: C
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Chapter 4: Adaptive Immunity
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Sample Questions
Q1) Which cell is capable of producing antibody?
A) Plasma cell
B) CD4+ T cell
C) Macrophage
D) Neutrophil
Q2) Mutations causing deficiencies in CD40L expression lead to an inability of helper T cells to:
A) kill tumor cells, resulting in an increased risk of cancer.
B) activate macrophages, resulting in an inability to clear extracellular pathogens.
C) migrate to the site of an infection by chemotaxis, resulting in a slowed response.
D) promote class-switching, resulting in high IgM and low IgA and IgG concentrations.
Q3) Immunoglobulin gene rearrangements occur in which stage of B-cell development?
A) Pro-B cell
B) Pre-B cell
C) Immature B cell
D) Mature B cell
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6
Chapter 5: Antibody Structure and Function
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Sample Questions
Q1) Which immunoglobulin activates the classical complement pathway?
A) IgD
B) IgM
C) IgA
D) IgE
Q2) Which of the following is a characteristic of IgA?
A) It is found in secretions.
B) It fixes complement.
C) It is a pentamer in serum.
D) It is the primary response antibody.
Q3) Which immunoglobulin causes allergic reactions as a result of release of histamine from mast cells?
A) IgA
B) IgE
C) IgD
D) IgM
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Chapter 6: Cytokines
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Sample Questions
Q1) Multiple cytokines are activated to cause similar biological effects.What is this process called?
A) Pleiotropy
B) Redundancy
C) Synergism
D) Antagonism
Q2) IL-3,IL-5,and several colony-stimulating factors all use a common subunit in their receptors.As a result,you would expect that they have what kind of actions?
A) Pleiotropic
B) Redundant
C) Autocrine
D) Paracrine
Q3) A protein released from a virally infected cell that protects other cells from viral invasion best describes:
A) IL-3.
B) interferon-alpha.
C) TNF.
D) IL-4.
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8
Chapter 7: Complement System
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Sample Questions
Q1) A decreased CH50 and a decreased AH50 would indicate a low amount of which of the following complement components?
A) C4
B) C3
C) C4 binding protein
D) Factor B
Q2) The C3 convertase of the alternative pathway of complement activation is:
A) C3bBbP.
B) C3bB.
C) C4b2a3b.
D) C4b2a.
Q3) The C5 convertase of the alternative pathway of complement activation is:
A) C4b.
B) C4b2a.
C) C4b2a3b.
D) C3bBb3bP.
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 is the proper concentration of sodium hypochlorite needed to disinfect your bench station?
A) 1:2
B) 1:5
C) 1:10
D) 1:20
Q3) 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
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Chapter 9: Principles of Serological Testing
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Sample Questions
Q1) If the assay was used to test a different population consisting of 240 infected patients and 50 healthy controls,which assay parameter would increase?
A)Sensitivity
B)Specificity
C)Positive predictive value
D)Negative predictive value
Q2) 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.
Q3) A blowout pipette would be labeled:
A) TD.
B) TC.
C) ML.
D) SD.
Q4) If complement interferes with test results,the serum sample should be:
A) treated with an anticoagulant.
B) frozen and thawed before testing.
C) heated to 56°C for 30 minutes.
D) centrifuged at 3,000 g for 30 minutes.
Page 11
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Chapter 10: Precipitation and Agglutination Reactions
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Sample Questions
Q1) Which antibody has the highest avidity for an antigen?
A) IgG containing Fab that each have an affinity of 4 × 10-?/M
B) Secretory IgA containing Fab that each have an affinity of 4 × 10-?/M
C) IgM containing Fab that each have an affinity of 1 × 10-?/M
D) IgE containing Fab that each have an affinity of 1 × 10-?
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) When carrier particles are coated with an antigen that is not normally found on them,this is known as:
A) direct agglutination.
B) passive agglutination.
C) reverse passive agglutination.
D) hemagglutination.
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12
Chapter 11: Labeled Immunoassays
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Sample Questions
Q1) Compared to a heterogeneous assay,a homogeneous assay:
A) is more sensitive.
B) requires more procedural steps.
C) is easier to adapt to automation.
D) is more specific.
Q2) A tissue section is fixed to a microscope slide,then incubated with a fluorescently labeled antibody that binds to an antigen expressed by cells in that tissue.The preparation is then washed and inspected with a fluorescent microscope.This technique is called:
A) direct immunofluorescence.
B) indirect immunofluorescence.
C) fluorescence polarization.
D) autofluorescence.
Q3) Which statement about noncompetitive enzyme immunoassays is true?
A) Binding sites for patient antigen are limited.
B) Washing in between steps is not necessary.
C) All patient antigen is allowed to react with binding sites.
D) Color is indirectly proportional to the concentration.
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Chapter 12: Molecular Diagnostic Techniques
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Sample Questions
Q1) What is the basis of strand displacement amplification?
A) Two different primers bind to the same strand of DNA.
B) Two different primers each bind to complementary strands of DNA.
C) Multiple primers bind to fragmented DNA targets.
D) Primers are joined together.
Q2) For a probe to hybridize to the target,which condition must be met?
A) The target must be double-stranded.
B) The target can only be RNA.
C) The target must have the same bases.
D) The target must have complementary bases.
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) In most flow cytometers,labeled cells:
A) scatter the light and absorb fluorescence.
B) absorb fluorescence and emit electronic impulses.
C) scatter the light and emit fluorescence.
D) absorb both fluorescence and light.
Q2) The expression of cell surface markers is determined in the flow cytometer by which of the following?
A) Chemiluminescence
B) Fluorescence
C) Optical density
D) Radioactivity
E) Scatter
Q3) A mature cytotoxic T cell expresses which markers?
A) CD3, CD4, and CD8
B) CD4, CD3, and CD5
C) CD5, CD8, and CD3
D) CD8, CD3, and CD2
Q4) In flow cytometry,fluorescence is usually used to determine:
A) intrinsic cell parameters.
B) extrinsic cell parameters.
15
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Chapter 14: Hypersensitivity
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Sample Questions
Q1) 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.
Q2) An exaggerated reaction directed against an antigen that is harmless is called:
A) atopy.
B) hypersensitivity.
C) immune complex disease.
D) passive cutaneous anaphylaxis.
Q3) Which of the following diseases is an example of a type II hypersensitivity?
A) Anaphylaxis
B) Myasthenia gravis
C) Post-streptococcal glomerulonephritis
D) Bruton's agammaglobulinemia
Q4) Which of the following occurs in hemolytic disease of the newborn?
A) IgE builds up on the mother's cells.
B) The Rh- mother is exposed to Rh+ baby cells.
C) The Rh+ mother is exposed to Rh- baby cells.
D) The baby must be Rh-.
Page 16
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Chapter 15: Autoimmunity
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Sample Questions
Q1) A 10-year-old girl visits her physician's office because she has been complaining about being thirsty and having to go to the bathroom all the time.She has lost 15 pounds over the past 6 months and has been more irritable than usual,especially after meals.The girl's fasting blood glucose is 575 mg/dL (reference range,< 100 mg/dL),her C-peptide is 0.5 ng/mL (reference range,0.8-3.1 ng/mL),and she has autoantibodies against glutamic acid decarboxylase and insulin.On the basis of these findings,a likely diagnosis for this girl is:
A) Hashimoto's thyroiditis.
B) acute glomerulonephritis.
C) type 1 diabetes.
D) progressive systemic sclerosis.
Q2) Screening and confirmation tests for antinuclear antibodies are typically performed by:
A) immunodiffusion followed by indirect immunofluorescence.
B) indirect immunofluorescence followed by enzyme immunoassay.
C) direct immunofluorescence followed by serum protein electrophoresis.
D) immunofixation electrophoresis followed by direct immunofluorescence.
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Page 17
Chapter 16: Transplantation Immunology
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Sample Questions
Q1) To determine whether a patient can accept a solid organ transplant from a nonrelated donor,which of the following tests would be used to verify compatibility after an HLA match is determined?
A) ABO blood typing
B) CDC assay
C) HLA antibody screen
D) RAST test
Q2) 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.
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Chapter 17: Tumor Immunology
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Sample Questions
Q1) A proto-oncogene is a normal gene that has a positive influence on cell proliferation.
A)True
B)False
Q2) Cancer antigen 19-9
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) An example of a tumor-specific antigen is the BCR/ABL protein for chronic myelogenous leukemia.
A)True
B)False
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Chapter 18: Immunoproliferative Diseases
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Sample Questions
Q1) Which statement regarding myelogenous leukemias is true?
A) They originate from a common colony-forming cell line.
B) They originate from a common myeloid precursor cell.
C) They originate from a common erythroid precursor cell.
D) They originate from a common megakaryocytic precursor cell.
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 of the following is not a characteristic in the identification of lymphoma of B-cell origin?
A) Surface immunoglobulins
B) Cell-surface proteins CD19 and CD20
C) Rearrangement of immunoglobulin genes
D) Presence of CD14 and CD15
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Chapter 19: Immunodeficiency Diseases
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Sample Questions
Q1) A 1-year-old boy is evaluated for a suspected immune deficiency.He has a history since birth of eczema,recurrent rashes,and diarrhea.His white blood cell count (WBC)count is 6.75/uL (normal values: 5.0-10.8 × 103 uL)with a normal differential.Platelet count is 35,000 (normal values: 150,000-350,000/uL),and the platelets are small.His IgG is 750 mg/dL (normal values: 600-1,500 mg/dL).IgM is 30 mg/dL (normal values; 75-150 mg/dL).IgA is 475 mg/dL (normal values: 50-125 mg/dL).IgE is 750 mg/dL (10-50 mg/dL).The boy's blood is typed as O-positive,and he does not have anti-A or anti-B antibodies.Flow cytometry performed on his blood shows 11% CD19 (normal values: 5%-20%)and 50% CD3 cells (normal values: 60%-80%)with a normal ratio of CD4:CD8.T-cell function tests are abnormal.This boy most likely has:
A) Bruton's tyrosine kinase deficiency.
B) Wiskott-Aldrich syndrome.
C) DiGeorge anomaly.
D) ataxia telangiectasia.
Q2) Leukocyte adhesion deficiency is caused by a defect in:
A) CD3.
B) CD18.
C) CD19.
D) CD25.
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Page 21
Chapter 20: Serological and Molecular Detection of Bacterial Infections
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Sample Questions
Q1) Which of the following is the first reaction in a lateral flow immunochromatographic assay?
A) Antigen reacts with a labeled antibody.
B) Antigen is captured by antibody immobilized at a specific location on a membrane.
C) Labeled antibody is captured by membrane-immobilized antibody.
D) Antibody reacts with a labeled antigen.
Q2) Which bacterium is transmitted via the fecal-oral route?
A) Streptococcus pyogenes
B) Mycoplasma pneumoniae
C) Rickettsia rickettsii
D) Helicobacter pylori
Q3) What is the main reason testing for cold agglutinins is no longer recommended to diagnose infection with Mycoplasma pneumonia?
A) It is difficult to perform.
B) False positives may be caused by certain viruses.
C) Very few people develop anti-I antibodies.
D) It requires expensive instrumentation.
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Page 22
Chapter 21: Spirochete Diseases
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Sample Questions
Q1) The antibody called reagin that is found in syphilis:
A) reacts with cardiolipin.
B) is specific for treponemal antigen.
C) appears in all patients within 7 days after exposure to syphilis.
D) is detected by the FTA-ABS test.
Q2) The vectors that transmit Borrelia burgdorferi from natural reservoirs to humans are:
A) deer.
B) mice.
C) ticks.
D) birds.
Q3) Which of the following is a cause of a laboratory-induced false-negative result in the screening tests for syphilis?
A) Alcohol ingestion prior to blood draw
B) Systemic lupus erythematosus
C) Excess serum antibody
D) Temperature greater than 30°C
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Chapter 22: Serological and Molecular Diagnosis of
Parasitic and Fungal
Infections
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Q1) Suppose a parasite invades a patient and causes disease.The patient develops immunity and is ultimately cured.This outcome is considered what type of host-parasite interaction?
A) Symbiosis
B) Commensalism
C) Sterilizing immunity
D) Concomitant immunity
Q2) A 27-year-old female patient who is pregnant is undergoing serological testing as a precaution because of a recent food poisoning episode in which she ate undercooked pork at a picnic.The laboratory tests revealed positive IgG antibodies and negative IgM antibodies to toxoplasmosis.What do these test results indicate?
A) She has an active infection, and there is risk of transmission to the fetus.
B) She does not have an active infection, and there is no risk to the fetus.
C) She has a chronic infection, and there is minimal risk to the fetus.
D) She has an active infection, and there is no risk to the fetus.
Q3) 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 patient has a hepatitis B profile performed and is positive for hepatitis B surface antibody only.This patient:
A) was vaccinated against hepatitis B
B) had a previous hepatitis B infection.
C) is a chronic carrier of hepatitis B.
D) has acute hepatitis B.
Q2) A patient has the following hepatitis profile: anti-HAV IgM = not detected; HBsAg = detected; anti-HBc IgM = detected; anti-HBc total = detected; anti-HBs = not detected; anti-HCV = not detected.What is his diagnosis?
A) Acute hepatitis A
B) Acute hepatitis B
C) Chronic hepatitis B
D) Immune to hepatitis B
Q3) In the routine diagnosis of hepatitis C virus,which type of laboratory test should be ordered first?
A) Antigen detection in liver biopsy
B) Antibody detection in blood
C) Viral culture of stool
D) Viral culture of biliary drainage
Page 25
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Chapter 24: Laboratory Diagnosis of HIV Infection
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Q1) p24
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) gp41
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
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) 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
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Chapter 25: Immunization and Vaccines
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Sample Questions
Q1) Trastuzumab,an antibody used in the treatment of breast cancer with an overexpression of the HER2 marker,is an example of a
A) mouse monoclonal antibody.
B) chimeric antibody.
C) humanized antibody.
D) fully human antibody.
Q2) Passive immunity
A) Immunization with a specific antigen
B) Transfer of antibodies from immunized host to nonimmune host
C) Transfer of cells, usually lymphocytes, from an immune host to a nonimmune host
Q3) An adverse reaction to a vaccine can involve hypersensitivity or an allergic reaction.
A)True
B)False
Q4) A mother provides immunity to her unborn child in the womb via which process?
A) Active immunity
B) Passive immunity
C) Adoptive immunity
D) Adoptive immunotherapy
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