Medical Diagnostics Exam Review
Course Introduction
Medical Diagnostics is a comprehensive course that explores the principles, techniques, and applications of diagnostic methods used in modern medicine. Students will gain an understanding of laboratory and imaging procedures such as blood tests, urinalysis, molecular diagnostics, X-rays, ultrasonography, CT, and MRI. The course covers the interpretation of diagnostic results, the integration of clinical findings, and the importance of accuracy and ethics in patient assessment. Emphasis is placed on the evolving role of technology in detecting, monitoring, and managing diseases, as well as the critical thinking skills necessary for making informed diagnostic decisions in diverse healthcare settings.
Recommended Textbook
Clinical Immunology and Serology A Laboratory Perspective 4th Edition by Christine Dorresteyn
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25 Chapters
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Chapter 1: Introduction to Immunity and the Immune System
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Sample Questions
Q1) Hematopoietic stem cells are located in the:
A) lymph nodes.
B) spleen.
C) bone marrow.
D) thymus.
Answer: C
Q2) All of the following are involved in adaptive immunity EXCEPT: A) memory.
B) lymphocytes.
C) specificity.
D) neutrophils.
Answer: D
Q3) Antibodies are secreted by:
A) plasma cells.
B) B cells.
C) T cells.
D) dendritic cells.
Answer: A
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Chapter 2: Nature of Antigens and the Major
Histocompatibility Complex
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Sample Questions
Q1) Which option best describes MHC class I antigens?
A) They are recognized by helper T cells.
B) They are found on all nucleated cells.
C) They combine with exogenous antigen.
D) They are coded for on chromosome 9.
Answer: B
Q2) Which option best describes a finding of Landsteiner's study of haptens?
A) Similar haptens trigger the same antibody response.
B) Spatial configuration is recognized by antibody.
C) Small chemical changes to a hapten do not affect antibody response.
D) A hapten can react with many different antibodies.
Answer: B
Q3) Antigens found in different species that trigger a similar antibody response are called:
A) heterophile antigens.
B) haptens.
C) alloantigens.
D) autoantigens.
Answer: A
Page 4
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Chapter 3: Innate Immunity
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Sample Questions
Q1) All of the following are characteristic of acute-phase reactants EXCEPT:
A) they are constituents that increase rapidly in response to infection.
B) they are used to diagnose a specific disease.
C) they enhance phagocytosis.
D) they limit destruction of host tissue.
Answer: B
Q2) Which of the following is part of the external defense system?
A) Ceruloplasmin
B) Skin
C) Neutrophils
D) Complement
Answer: B
Q3) Which of the following have the highest concentrations of Toll-like receptors?
A) B-cells
B) Monocytes
C) Natural killer cells
D) T cells
Answer: B
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5
Chapter 4: Adaptive Immunity
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Sample Questions
Q1) A cell that can recall previous contact with a particular antigen so that subsequent exposure leads to a more rapid and more effective immune response than the first encounter is which type of cell?
A) Memory lymphocyte
B) Effector lymphocyte
C) Plasma cell
D) Stem cell
Q2) Cytotoxic T cells are the primary immune response against which type of pathogen?
A) Viruses
B) Parasites
C) Bacteria
D) Fungi
Q3) The receptor for antigen on a mature naïve B cell is:
A) class I MHC.
B) class II MHC.
C) IgG.
D) IgM.
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Page 6
Chapter 5: Antibody Structure and Function
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Sample Questions
Q1) IgA in secretions has a valence of:
A) 1.
B) 2.
C) 4.
D) 10.
Q2) IgD is produced by:
A) differential splicing of the RNA transcript.
B) differential splicing of the DNA transcript.
C) constant gene-region rearrangement.
D) immature B cells.
Q3) Which immunoglobulin appears in the highest titer in the secondary response?
A) IgG
B) IgA
C) IgM
D) IgD
Q4) Bence-Jones proteins are identical to:
A) secretory IgA.
B) heavy chains.
C) light chains.
D) IgG molecules.
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Chapter 6: Cytokines
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Sample Questions
Q1) Cytokines exhibit pleiotropy,which refers to:
A) multiple cytokines affecting the same cell.
B) one cytokine inhibiting the activity of another cytokine.
C) one cytokine affecting multiple cells.
D) cytokines acting together to affect a cell.
Q2) Multiple cytokines are activated to cause similar biological effects.What is this process called?
A) Pleiotropy
B) Redundancy
C) Synergism
D) Antagonism
Q3) Erythropoietin regulates:
A) T-cell function.
B) bone marrow cell differentiation.
C) proinflammatory cytokine synthesis.
D) the acute-phase response.
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Chapter 7: Complement System
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Sample Questions
Q1) The target recognition molecule of the lectin pathway that initiates complement activation is:
A) C1q.
B) C4.
C) C5b6789.
D) mannose-binding lectin.
Q2) Which protein inhibits the classical complement pathway at the very beginning of the pathway?
A) C1INH
B) C4BP
C) C3BP
D) Factor H
Q3) Which of the following is cleaved first by C1qrs in the classical pathway of complement activation?
A) C2
B) C3
C) C4
D) Factor B
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9
Chapter 8: Safety and Quality Management
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Sample Questions
Q1) In performing routine quality control on a particular laboratory test,a high-quality control value is obtained that changes the mean.What type of change does this represent?
A) Trend
B) Standard deviation
C) Shift
D) Central tolerance
Q2) A patient under isolation precautions is being transported to the x-ray department.He has no mask on and sneezes in the elevator.This scenario is an example of what type of hazard?
A) Chemical hazard
B) Sharps hazard
C) Chain-of-infection hazard
D) Physical hazard
Q3) Where should you dispose of blood-soaked gauze pads?
A) Regular garbage
B) Sharps container
C) Red biohazard bag
D) Laundry bag
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Page 10
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) Which series of dilutions would be best in order to make a 1:3000 dilution?
A) 1:10, 1:3, 1:10
B) 1:5, 1:6, 1:100
C) 1:3, 1:100, 1:100
D) 1:30, 1:10, 1:100
Q3) What is the sensitivity of the assay?
A)57%
B)75%
C)80%
D)90%
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 particle-counting immunoassay method counts the number of:
A) agglutinated particles.
B) free antibody molecules.
C) free latex particles.
D) antigen-antibody bonds.
Q2) Which of the following is characteristic of a passive agglutination test?
A) The antigen is naturally found on particles.
B) Antigen molecules are artificially bound to particles.
C) Antibody is attached to particles.
D) The antigen-antibody reaction is competitive (no agglutination indicates a positive result).
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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Chapter 11: Labeled Immunoassays
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Sample Questions
Q1) Pregnancy testing can be performed at home using:
A) capture assay.
B) immunochromatography.
C) fluorescence polarization.
D) chemiluminescence.
Q2) Extremely high analyte concentrations can cause false-negative results (hook effect)in which type of assay?
A) Homogeneous competitive
B) Heterogeneous competitive
C) Homogeneous noncompetitive
D) Heterogeneous noncompetitive
Q3) Select the technique that would most likely be used to determine the concentration of a therapeutic drug.
A) Radioimmunoassay
B) Chemiluminescent assay
C) Fluorescence polarization immunoassay
D) Enzyme immunoassay
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13
Chapter 12: Molecular Diagnostic Techniques
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Sample Questions
Q1) ddNTPs terminate the lengthening of a DNA strand because they lack chemical groups that:
A) allow hydrogen bonding to the template strand.
B) are recognized by DNA polymerase.
C) protect the strand from endonucleases.
D) form phosphodiester bonds in the backbone of the strand.
Q2) How would you interpret results of DNA restriction analysis by gel electrophoresis if there was 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.
Q3) In the process of translation,the addition of a particular amino acid to a growing protein may be specified by:
A) one specific mRNA nucleotide.
B) only one specific combination of three mRNA nucleotides.
C) one of several specific combinations of three mRNA nucleotides.
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Page 14
Chapter 13: Flow Cytometry and Laboratory Automation
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Sample Questions
Q1) In flow cytometry,it is possible to detect the expression of 10 different cell membrane proteins simultaneously by:
A) using 10 different lasers that produce light at different wavelengths.
B) measuring the amount of light scattered at 10 different angles.
C) staining the cells with 10 different labeled probes that fluoresce at different wavelengths.
D) measuring mass as well as fluorescent intensity.
Q2) The lowest measurable amount of an analyte is called:
A) accuracy.
B) precision.
C) analytic sensitivity.
D) analytic specificity.
Q3) A test system is producing many false-positive results.You suspect this is a problem involving:
A) analytic specificity.
B) precision.
C) analytic sensitivity.
D) a sampling error.
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Chapter 14: Hypersensitivity
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Sample Questions
Q1) A positive direct antiglobulin test might indicate:
A) autoimmune hemolytic anemia.
B) an allergic reaction.
C) a mismatch of a transplant.
D) rheumatoid arthritis.
Q2) A direct antiglobulin test is ordered on a patient sample.This test detects:
A) in vivo attachment of antibodies to red blood cells.
B) allergic reaction.
C) passive agglutination.
D) naturally occurring antibodies.
Q3) The 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
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16
Chapter 15: Autoimmunity
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Sample Questions
Q1) A perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA)staining pattern consists of:
A) diffuse, granular staining at the outer edges of the cell cytoplasm.
B) a continuous fluorescent ring (rim) in the cytoplasm, close to the plasma membrane.
C) fluorescence surrounding the lobes of the nuclei.
D) dense staining of neutrophilic granules.
Q2) Citrullinated proteins:
A) are modified by carbohydrate side chains.
B) contain modified (atypical) amino acids.
C) are denatured nucleic acids.
D) are microbial toxins.
Q3) Systemic lupus erythematosus is characterized by:
A) HLA-DR antigens expressed on thyroid epithelial cells.
B) increase in cells lining the synovial membrane.
C) absence of immune complexes.
D) presence of dsDNA antibodies.
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Chapter 16: Transplantation Immunology
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Sample Questions
Q1) Which of the following is characteristic of an acute graft-versus-host disease episode?
A) The reaction occurs within 100 days of the transplant.
B) The reaction involves the skin, gastrointestinal (GI) tract, and liver.
C) The reaction produces a fibrous condition of the mouth and eyes.
D) The reaction involves the recipient's bone marrow.
Q2) Which histocompatibility system activates gamma or delta T-cell receptors?
A) ABO blood group antigen
B) Killer immunoglobulin-like receptors
C) MHC class-I related chain A (MICA) antigen
D) Minor histocompatibility antigens
Q3) A transplantation patient suffers an organ rejection within hours after the procedure.What type of rejection occurred?
A) Hyperacute
B) Acute
C) Chronic
D) Graft-versus-host disease
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18
Chapter 17: Tumor Immunology
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Sample Questions
Q1) Which of the following is a clinical application for tumor markers?
A) Screening
B) Diagnosis
C) Monitoring
D) All of the above
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) A proto-oncogene is a normal gene that has a positive influence on cell proliferation.
A)True
B)False
Q4) A tumor-specific antigen is:
A) a general marker for all known human tumors.
B) a specific marker for leukemias.
C) unique to the tumor of an individual patient.
D) nonspecific to all patient populations.
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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 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
Q3) What is the correct order of protein migration,starting at the cathode and moving to anode,following serum protein electrophoresis?
A) Albumin, gamma, alpha 1, alpha 2, beta
B) Albumin, alpha 1, alpha 2, beta, and gamma
C) Gamma, beta, alpha 2, alpha 1, albumin
D) Beta, gamma, alpha 2, and alpha 1, albumin
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Chapter 19: Immunodeficiency Diseases
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Sample Questions
Q1) Patients with recombinase activating gene 1 (RAG-1)or RAG-2 deficiencies have decreased numbers of:
A) monocytes.
B) granulocytes.
C) lymphocytes.
D)all of the above.
Q2) 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.
Q3) The buildup of toxic purine metabolites that impair B- and T-cell proliferation is the result of a mutation in the gene coding for:
A) recombinase activating gene 1 or 2.
B) JAK3 kinase.
C) mevalonate kinase.
D) adenosine deaminase.
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21
Chapter 20: Serological and Molecular Detection of Bacterial Infections
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Sample Questions
Q1) Which bacterial infections are routinely diagnosed by measuring host antibodies that neutralize the microbe's exotoxins?
A) Streptococcus pyogenes
B) Mycoplasma pneumoniae
C) Rickettsia rickettsii
D) Helicobacter pylori
Q2) Which bacterium does not cause fever?
A) Streptococcus pyogenes
B) Mycoplasma pneumoniae
C) Rickettsia rickettsii
D) Helicobacter pylori
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.
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Chapter 21: Spirochete Diseases
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Sample Questions
Q1) The VDRL test on cerebrospinal fluid for neurosyphilis:
A) is very specific.
B) is very sensitive.
C) does not require the use of a microscope.
D) uses a higher antigen volume than the serum test.
Q2) The clinical hallmark of early Lyme disease infection is:
A) a chancre.
B) erythema migrans.
C) chronic fatigue.
D) a gumma.
Q3) Which of the following is a cause of a biological false-negative result in the nontreponemal tests for syphilis?
A) Rotated too long
B) Rheumatoid arthritis
C) Secondary syphilis
D) Slow rotator speed
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Chapter 22: Serological and Molecular Diagnosis of Parasitic
and Fungal
Infections
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Sample Questions
Q1) Eosinophilia and an increase in which immunoglobulin play a role in the defense against parasites?
A) IgA
B) IgD
C) IgE
D) IgG
Q2) Suppose a parasite invades a patient and causes disease.The patient develops an immune response and has some resistance to the parasite but is not cured.This outcome is considered what type of host-parasite interaction?
A) Symbiosis
B) Commensalism
C) Sterilizing immunity
D) Concomitant immunity
Q3) A patient has been diagnosed with tapeworm.Identify the type of parasitic organism involved.
A) Protozoa
B) Helminth
C) Ectoparasite
D) Host
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Chapter 23: Serology and Molecular Detection of Viral
Infections
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Sample Questions
Q1) A positive rubella titer in a healthy,nonpregnant 22-year-old female most likely indicates which of the following?
A) Immunity after administration of the vaccine
B) Current presence of the disease
C) No immunity
D) Possibility of congenital rubella
Q2) Which types of hepatitis are transmitted primarily through contact with blood or other body fluids?
A) Hepatitis B, C, and D
B) Hepatitis A, B, and C
C) Hepatitis A, C, and E
D) Hepatitis C, D, and E
Q3) Which test is most specific for infectious mononucleosis?
A) Monospot
B) CBC with differential
C) Anti-EBV titers
D) Paul-Bunnell test
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Page 25
Chapter 24: Laboratory Diagnosis of HIV Infection
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Sample Questions
Q1) The RT-PCR is a highly sensitive method that involves:
A) direct amplification of HIV RNA.
B) amplification of a label attached to HIV RNA.
C) amplification of a complementary DNA sequence to a portion of the HIV RNA.
D) DNA sequencing of a portion of HIV RNA.
Q2) 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
Q3) Histoplasmosis (disseminated or extrapulmonary)is an opportunistic infection of stage 3 HIV infection.
A)True
B)False
Q4) Of the designated subtypes of HIV,which is the most common in the United States?
A) Subtype B
B) Subtype C
C) Subtype A
D) Subtype K
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Chapter 25: Immunization and Vaccines
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Sample Questions
Q1) An adverse reaction to a vaccine can involve hypersensitivity or an allergic reaction.
A)True
B)False
Q2) Suppose you are a graduate student working in a research laboratory that focuses on the development of new vaccines.Your faculty mentor asks you to play a key role in the development of a vaccine for a novel pathogen by using reverse vaccinology.Your project design should involve:
A) screening the genome of the pathogen to identify genes that code for potential vaccine targets.
B) culturing the organism, isolating proteins that could serve as vaccine antigens, and cloning the genes for those proteins.
C) developing a universal vaccine that could provide broad protection against a group of related organisms.
D) using a prime-boost strategy to stimulate an effective immune response.
Q3) Human immune serum globulin is made from the pooled serum of thousands of donors.
A)True
B)False
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