Diagnostic Immunology Practice Exam
Course Introduction
Diagnostic Immunology explores the principles and applications of immunology in the diagnosis of diseases. The course covers the structure and function of the immune system, antigen-antibody interactions, and the development of immune responses. Students will learn about various immunological techniques such as ELISA, immunofluorescence, flow cytometry, and western blotting, as well as their roles in detecting infections, autoimmune disorders, immunodeficiencies, and allergies.
Emphasis is placed on interpreting laboratory results and understanding quality control in diagnostic testing. The course prepares students to apply immunological methods in clinical laboratories and research settings.
Recommended Textbook
Clinical Immunology and Serology A Laboratory Perspective 3rd Edition by Christine Dorresteyn
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22 Chapters
562 Verified Questions
562 Flashcards
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Chapter 1: Introduction and Natural Immunity
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49 Verified Questions
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Sample Questions
Q1) A patient is tested for the presence of C-reactive protein and is found to have an elevated level.What does this indicate is taking place in the patient?
A) inflammation
B) nothing,the patient is normal
C) impossible to determine anything
Answer: A
Q2) If a slide test for CRP is positive,what does this indicate?
A) It is a nonspecific indicator of inflammation.
B) Patient has lupus.
C) Patient is immunocompromised.
D) Patient has a strep infection.
Answer: A
Q3) The phagosome of a macrophage is a membrane-bound vesicle that contains:
A) enzymes
B) reactive oxygen intermediates
C) ingested bacteria
D) perforin and granzymes
Answer: C
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3
Chapter 2: Lymphoid System
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Sample Questions
Q1) Lymphocytes that mature in the thymus are involved in which immune response?
A) cytokine-mediated responses
B) antibody production
C) phagocytosis
D) any of the above
Answer: A
Q2) The function of T cells with CD4 antigen is which of the following?
A) to help B cells make antibody
B) to kill virally infected cells
C) phagocytosis
D) production of opsonins
Answer: A
Q3) The receptor for antigen on a mature naïve B cell is:
A) MHC class I
B) IgG
C) IgM
D) MHC class II
Answer: C
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Chapter 3: Nature of Antigens and Major Histocompatibility Complex
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38 Verified Questions
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Sample Questions
Q1) If a person has a reaction to poison ivy,this is due to:
A) an autocoupling hapten
B) a heterophile antigen
C) a T-independent antigen
D) use of an adjuvant
Answer: A
Q2) Blood from a suspect is typed to see if it is a match with a sample found at the crime scene.The suspect's blood exhibits the following reactions: no agglutination with anti-A,no agglutination with anti-B.What is the suspect's blood type?
A) type A
B) type B
C) type O
D) type AB
Answer: C
Q3) Which of the following is likely to be the most immunogenic?
A) a lipid with a molecular weight of 50,000 d
B) a polysaccharide with a molecular weight of 40,000 d
C) a protein with a molecular weight of 45,000 d
D) a nucleic acid with a molecular weight of 60,000 d
Answer: C
Page 5
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Chapter 4: Antibody Structure and Function
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Sample Questions
Q1) When papain is used to cleave antibody molecules,what are the products?
A) 2 Fab and Fc
B) two L chains and two H chains
C) VL,CL,VH,and CH
Q2) The theory that lymphocytes are preprogrammed to respond to a particular type of antigen best describes:
A) the clonal selection theory
B) Ehrlich's side chain theory
C) the spontaneous generation theory
D) Edelman's antibody formation theory
Q3) The region of an antibody molecule that exhibits the greatest variability from antibody to antibody is known as the:
A) hypervariable region
B) constant region
C) Fc region
D) all of the above
Q4) Which region of the immunoglobulin molecule can bind antigen?
A) Fab
B) CL
C) CH
Page 6
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Chapter 5: Cytokines
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Sample Questions
Q1) IL-2 is a cytokine that could be more specifically called which of the following because of the cells that produce it?
A) lymphokine
B) monokine
C) basokine
D) eokine
Q2) Which of the following can be attributed to interleukin-6 (IL-6)?
A) stimulates red blood cell production
B) increases vascular permeability
C) inhibits antigen presentation by macrophages
D) increases activation of T and B cells
Q3) What is the main function of chemokines?
A) inhibit the immune response
B) enhance synthesis of acute phase reactants
C) enhance migration of white blood cells
D) protect cells from viral invasion.
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Chapter 6: Complement System
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Sample Questions
Q1) Which factor is unique to the lectin pathway?
A) factor B
B) C1q
C) mannose-binding protein
D) factor I
Q2) Lack of the complement inhibitor C1INH results in which disease?
A) hereditary angioedema
B) paroxysmal nocturnal hemoglobinuria
C) immune complex disease
D) meningitis
Q3) The target recognition molecule of the lectin pathway that initiates complement activation is:
A) C1q
B) C4
C) C5b6789
D) mannose-binding lectin
Q4) What is cleaved by C3bBb?
A) C3
B) C5
C) C6
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Chapter 7: Safety and Specimen Preparation
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Sample Questions
Q1) Which of the following applies to recapping of needles?
A) It can be done carefully as long as gloves are worn.
B) A sheath can be placed back on the needle with the other hand.
C) Transport needles back to the lab for disposal.
D) Never manually recap a needle.
Q2) Which of the following is part of the federal Occupational Exposure to Bloodborne Pathogens Standard Act ?
A) All employees must practice universal precautions at all times.
B) Only workers who come in contact with patients need to wear gloves.
C) Taking a cup of coffee into the lab is okay as long as it doesn't spill.
D) A blood spill can be mopped up at the end of the day.
Q3) When a staphylococcal infection is passed between patients due to health-care workers not washing their hands,this represents an example of:
A) lack of chemical hygiene
B) a sharps hazard
C) the chain of infection
D) a specimen transport problem
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9
Chapter 8: Precipitation Reactions
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Sample Questions
Q1) A situation in which antigen is in excess as compared to antibody is called:
A) prozone
B) postzone
C) equivalence zone
Q2) Which of the following might adversely affect an electrophoresis reaction?
A) decreasing the strength of the current
B) changing the pH of the buffer
C) increasing the strength of the current
D) all of the above
E) all except one of the above
Q3) The radial immunodiffusion test is a method involving:
A) agglutination
B) flocculation
C) precipitation
D) neutralization
Q4) In an Ouchterlony immunodiffusion procedure,a continuous arc of precipitate is observed between two adjacent wells.This is a reaction of:
A) identity
B) non-identity
C) partial identity
Page 10
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Chapter 9: Agglutination
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Sample Questions
Q1) A serological reaction is set up in which the antigen is bound to a large carrier,the antibody is soluble,and they bind and form an insoluble complex that is detected macroscopically.What type of assay is described?
A) precipitation
B) agglutination
C) flocculation
D) neutralization
Q2) What would be the best test to determine evidence of hemolytic disease of the newborn?
A) direct antiglobulin testing
B) passive agglutination
C) coagglutination testing
D) indirect antiglobulin testing
Q3) If a Coombs' test is positive,which of the following is true?
A) Antibody has coated patient red blood cells in vitro.
B) Antigen is reacting with patient antibody.
C) Antibody has coated patient red blood cells in vivo.
D) Antigen has coated patient red blood cells in vivo.
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Chapter 10: Labeled Immunoassays
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Sample Questions
Q1) In a sandwich or capture assay to determine the presence of a viral antigen in a patient sample,which of the following would be on solid phase?
A) antigen
B) labeled antibody
C) unlabeled antibody
D) antihuman immunoglobulin
Q2) In an indirect fluorescent immunoassay such as the FTA confirmatory test for syphilis,all of the following are true EXCEPT:
A) A labeled antigen is used.
B) Washing is an important step.
C) Patient antibody is detected.
D) Antihuman globulin has a fluorescent tag.
Q3) Indirect immunofluorescence is similar to which type of enzyme immunoassay as far as the performance of the assay?
A) competitive
B) sandwich
C) ELISA
D) homogeneous
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12
Chapter 11: Molecular Techniques
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Sample Questions
Q1) Which is the correct conclusion if results of DNA restriction analysis by gel electrophoresis show a difference in one band?
A) The samples are the same.
B) The samples are not identical.
C) Gel electrophoresis should be repeated.
D) The wrong buffer was used in electrophoresis.
Q2) In order 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) What is meant by semi-conservative replication of DNA?
A) Only part of the molecule is reproduced at one time.
B) Each strand is the template for another strand.
C) One copy is the same and another copy is different.
D) DNA uses RNA to make new copies.
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Chapter 12: Flow Cytometry and Laboratory Automation
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Sample Questions
Q1) 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
Q2) As measured in flow cytometry,cells that are the smallest and have the least granules would be identified as:
A) lymphocytes
B) granulocytes
C) monocytes
D) erythrocytes
Q3) What is meant by "gating" in flow cytometry?
A) the chromatic arrangement of cellular populations
B) process by which one cell population adheres to another population
C) an electronic window separating subpopulations of cells
D) an electronic device measuring all populations of cells
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14
Chapter 13: Hypersensitivity
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Sample Questions
Q1) Precipitation of immune complexes in small blood vessels under the skin that occurs when antigen is injected in an animal with large amounts of circulating antibody describes which of the following?
A) serum sickness
B) Arthus reaction
C) anaphylaxis
D) delayed hypersensitivity
Q2) T cell-dependent hypersensitivity occurs:
A) 24 to 72 hours after exposure to the antigen
B) immediately after exposure to the antigen
C) 5 to 7 days after contact with antigen
D) 1 to 4 hours after contact with antigen
Q3) Anaphylactic reactions are mediated by:
A) mast cells
B) lymphocytes
C) macrophages
D) natural killer cells
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Chapter 14: Autoimmunity
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Sample Questions
Q1) A 16-year-old male goes to his physician for an annual checkup.A routine urinalysis indicates the presence of blood,an increase in protein,and an increase in urea.The young man reports that he has been feeling tired and has a persistent cough.The doctor orders additional lab testing,including a serum test for rheumatoid factor,antinuclear antibody testing,anti-streptolysin O testing,and testing for the presence of anti-basement membrane antibodies.Only the latter test was positive.What is the most likely cause of the symptoms?
A) lupus
B) Goodpasture's syndrome
C) multiple sclerosis
D) rheumatoid arthritis
Q2) Lupus can be distinguished from rheumatoid arthritis on the basis of which of the following?
A) joint pain
B) presence of inflammation
C) deposition of immune complexes in the kidney
D) antibody to acetylcholine receptors
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Page 16
Chapter 15: Immunoproliferative Diseases
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Sample Questions
Q1) What is the interpretation of the following patient results? (normal values)WBC = 90.0 th/uL (5.0-10.0 th/uL,),with 89% lymphs (20-40%); CD3 = 90% (60-80%); CD5 = 87% (60-80%); CD10 = 0% (< 1%); CD4 = 88% (30-65%); CD20 = 12% (5-20%); CD34 = 0% (< 1%); CD8 = 3% (10-40%); kappa = 10% (3-15%); lambda = 5% (2-10%); CD19 = 15% (5-20%).
A) normal
B) B-cell acute leukemia
C) T-cell acute leukemia
D) B-cell chronic leukemia
E) T-cell chronic leukemia
Q2) A 55-year-old male presents with symptoms that include weakness,loss of appetite,and anemia.Immunofixation electrophoresis reveals a heavy IgM band.Which of the following is the most likely diagnosis?
A) SCID
B) multiple myeloma
C) Waldenström's macroglobulinemia
D) DiGeorge syndrome
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Chapter 16: Immunodeficiency Disease
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Sample Questions
Q1) Which of the following statements about severe combined immunodeficiency (SCID)are true?
A) may be associated with a signal transduction defect
B) is accompanied by hypergammaglobulinemia
C) patients can be vaccinated with live virus
D) occurs only in males
Q2) A male baby who has suffered from persistent Candida fungal infections and several bouts of pneumonia all before the age of 6 months is found to have some developmental problems as well as low-set ears.Lab testing reveals an absence of T cells.What is the most likely diagnosis?
A) selective IgA deficiency
B) common variable immunodeficiency
C) Waldenström's macroglobulinemia
D) DiGeorge syndrome
Q3) Which of the following diseases results in an acquired or secondary immunodeficiency?
A) HIV infection
B) Bruton's agammaglobulinemia
C) leukocyte adhesion deficiency
D) Wiskott-Aldrich syndrome
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Chapter 17: Transplantation Immunology
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Sample Questions
Q1) Which term applies to the type of graft rejection that begins within a few weeks or months after transplantation of an organ and is due to CD8 reactive T cells?
A) acute rejection
B) hyperacute rejection
C) chronic rejection
D) accelerated rejection
Q2) Graft-versus-host disease results under which conditions?
A) when immunocompetent cells are placed in an immunocompromised host
B) when immunodeficient cells are placed in an immunocompetent host
C) any time tissue is not exactly matched in a transplant
D) only when adult cells are transplanted into a baby
Q3) When a complement-dependent cytotoxicity test was performed using standard antibodies to HLA A1,A3,B2,and B11,the following microscopic results were obtained: a majority of blue cells were seen with anti-A1,A3,and B11.Based on these results,what is the phenotype of the donor cells?
A) HLA A1,B11
B) HLA B2 only
C) HLA A1,A3,B11
D) cannot be determined from these results
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Page 19
Chapter 19: Tumor Immunology
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Sample Questions
Q1) Antibodies detected by reacting rickettsial antigens with specific antibody followed by use of an anti-immunoglobulin with a fluorescent tag could be used to diagnose:
A) Rocky Mountain spotted fever
B) Mycoplasma pneumonia
C) stomach ulcers
D) rheumatic fever
Q2) All of the following are tests used to identify Helicobacter pylori EXCEPT:
A) polymerase chain reaction
B) urease
C) enzyme immunoassay
D) DNase
Q3) Which of the following bacterial enzymes causes the release of lysosomal contents into the cytoplasm of the phagocytic cell,leading to the death of the cell?
A) protein H
B) leukocidin
C) M protein
D) IgA protease
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Chapter 20: Serologic and Molecular Detection of Bacterial
Infections
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Sample Questions
Q1) Which statement best describes antigenic variation seen in parasites?
A) The host immune system can respond more quickly.
B) Different parasites have different antigens.
C) Parasites can periodically change their surface antigens.
D) Parasites become sequestered in host cells.
Q2) A host's immunological response to parasites includes all of the following EXCEPT:
A) formation of IgG,IgM,and IgA antibodies
B) production of cytokines
C) gamma-interferon production by natural killer cells
D) sequestering the parasite in host cells
Q3) When is antibody testing for Cryptococcal antibodies most useful?
A) in determining patient prognosis
B) in diagnosing immunocompromised patients
C) in ruling out the disease in young patients
D) as a screening test after exposure to the fungus
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21
Chapter 21: Serologic and Molecular Detection of Bacterial
Infections
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Sample Questions
Q1) A 30-year-old man presents to the physician with a painless ulcer on his penis.An RPR performed on the man is reactive 1:128,and the MHA-TP test is positive.This man has:
A) Neisseria gonorrhoeae
B) Chlamydia trachomatis
C) Treponema pallidum
D) Mycoplasma hominis
Q2) The RPR and VDRL are similar in which of the following ways? RPR and VDRL are both:
A) read macroscopically
B) flocculation reactions
C) specific assays for syphilis
D) antigen detection assays
Q3) A patient presents with personality changes,altered mental state,and delusions of grandeur.The patient is then diagnosed as having syphilis.In what stage of syphilis is the patient?
A) primary
B) secondary
C) latent
D) tertiary
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Chapter 22: Serology of Parasitic and Fungal Infections
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Sample Questions
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 36-year-old African American male presents to a free clinic with symptoms of anorexia,malaise,vomiting,abdominal pain,and mild jaundice.The patient is a known IV drug abuser.The physician orders liver function tests and an acute hepatitis serum panel.The laboratory reports the following results: anti-HAV IgM = not detected; HBsAg = not detected; anti-HBc IgM = not detected; anti-HBc total = detected; anti-HBs = detected; anti-HCV = detected.This man has:
A) acute hepatitis B
B) chronic hepatitis B
C) acute hepatitis A
D) acute hepatitis C
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Chapter 23: Spirochete Diseases
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Sample Questions
Q1) A 25-year-old male presents to the public health clinic complaining of flu-like symptoms.The man has been an IV drug user and prostitute for the last 5 years.HIV antibody screening is positive.Subsequently,antibodies are found to have specificity for p24,gp120,p31,and gp41.This patient has:
A) current HIV infection
B) indeterminate HIV infection
C) lack of HIV infection
D) infection with some other virus
Q2) Which technique is most widely used for the confirmation of a positive serologic assay for antibodies against HIV?
A) enzyme-linked immunosorbent assay (ELISA)
B) complement fixation
C) Western blot assay
D) polymerase chain reaction
Q3) The HIV p24 protein encodes:
A) group-specific antigen (GAG)
B) the receptor for host cells (ENV)
C) reverse transcriptase (POL)
D) none of these
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Page 24