Pathology Laboratory Techniques
Practice Exam
Course Introduction
Pathology Laboratory Techniques is designed to introduce students to the foundational methods and procedures used in a modern pathology laboratory. The course covers essential topics such as specimen collection, processing, and preservation, tissue fixation, embedding, sectioning, and staining techniques, as well as the use of laboratory instruments and safety protocols. Students will gain practical skills in microscopy, histological and cytological analysis, and learn quality control measures essential for accurate diagnostic outcomes. Emphasis is placed on understanding the principles underlying each technique and their application in clinical and research settings, equipping students with the competence required for a career in laboratory medicine.
Recommended Textbook
Clinical Immunology and Serology A Laboratory Perspective 3rd Edition by Christine Dorresteyn
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562 Flashcards
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Chapter 1: Introduction and Natural Immunity
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Sample Questions
Q1) A protein that only changes in concentration significantly in response to inflammation and is not detectable when there is no inflammation is called a/an:
A) reagin
B) immunoglobulin
C) complement protein
D) acute phase protein
Answer: D
Q2) The respiratory burst is:
A) an increase in oxygen consumption
B) pseudopodia extending around a particle
C) the release of granules from a cell
D) the sudden exhale of a cell
Answer: A
Q3) Neutrophils are characterized by all of the following EXCEPT:
A) found in the marginating pool in blood vessels
B) capable of diapedesis
C) granules stain bright orange with Wright stain
D) segmented nucleus
Answer: C
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Page 3
Chapter 2: Lymphoid System
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Sample Questions
Q1) The cells that primarily function by secreting large amounts of cytokines are:
A) plasma cells
B) B cells
C) T helper cells
D) cytotoxic T cells
Answer: C
Q2) A lymphocyte exhibits the following markers: CD19,IgM,IgD.What is its likely identity?
A) double-negative T cell
B) immature B cell
C) double-positive T cell
D) mature B cell
Answer: D
Q3) Which of the following would be found on the surface of a pre-B cell?
A) delta and kappa chains
B) gamma and lambda chains
C) epsilon and kappa chains
D) mu and surrogate light chains
Answer: D
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4
Chapter 3: Nature of Antigens and Major Histocompatibility Complex
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Sample Questions
Q1) If a mother is HLA A3A14/ B5B15/ Cw3Cw4,and her child is A3A9/B5B27/Cw4Cw7,which of the following men is the most likely candidate for the father?
A) A5A9/B5B27/Cw3Cw7
B) A9A11/B15B21/Cw1Cw4
C) A4A15/B2B27/Cw1Cw5
D) A5A9/B17B27/Cw3Cw5
Answer: A
Q2) If a patient's red cells agglutinate with anti-A reagent antibody and the serum agglutinates B cells,what is the blood type?
A) type A
B) type B
C) type O
D) cannot determine
Answer: A
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Chapter 4: Antibody Structure and Function
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Sample Questions
Q1) 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
Q2) Which immunoglobulin can cross the placenta?
A) IgM
B) IgE
C) IgA
D) IgG
Q3) The primary response is characterized by:
A) naive B cells recognizing antigens
B) memory B cells recognizing antigens
C) the production of large amounts of IgG
D) a very short lag period
E) a long duration of high titer
Q4) 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
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Chapter 5: Cytokines
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Sample Questions
Q1) When multiple cytokines act on the same cell,by definition they have:
A) pleiotropy
B) redundancy
C) synergism
D) antagonism
Q2) When Il-2 acts on T cells,B cells,and NK cells,this is an example of:
A) redundancy
B) pleiotropy
C) synergy
D) antagonism
Q3) 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
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Chapter 6: Complement System
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Sample Questions
Q1) A patient has an abnormal alternative pathway activation pattern.Which of the following complement proteins should be assessed to further elucidate the problem?
A) C1
B) C2
C) C3
D) C4
Q2) All of the following statements are true of C3 EXCEPT:
A) It is known as the recognition unit.
B) It plays a key role in all pathways.
C) It is the most abundant of the complement proteins.
D) Its major function is opsonization.
Q3) The C5 convertase of the alternative pathway of complement activation is:
A) C4b
B) C4b2a
C) C4b2a3b
D) C3bBb3bP
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8
Chapter 7: Safety and Specimen Preparation
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Sample Questions
Q1) If 0.9 mL of saline is added to 0.1 mL of serum,what does the 0.9 mL represent?
A) the final dilution
B) the diluent
C) the solute
D) the total solution
Q2) Information on any potentially toxic substance used in a laboratory test kit would be found in:
A) OSHA's Occupational Exposure to Bloodborne Pathogens Standard
B) chemical hygiene plan
C) material safety data sheet
D) exposure control plan
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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Chapter 8: Precipitation Reactions
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Sample Questions
Q1) In the Mancini endpoint method of RID:
A) The diameter is proportional to the log of the concentration of antigen.
B) The squared diameter is proportional to the concentration of antigen.
C) The squared diameter is proportional to the log of the concentration of antigen.
D) The diameter is directly proportional to the concentration.
Q2) An Ouchterlony immunodiffusion assay is set up and a line of precipitation is seen forming between the antigen and antibody wells.The lines of precipitation formed by two adjacent antigen wells cross each other,forming an X.The reaction described is called:
A) identity
B) non-identity
C) partial identity
Q3) The Western blot test used to confirm HIV is an example of which of the following?
A) immunofixation
B) immunoelectrophoresis
C) double diffusion
D) passive agglutination
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Chapter 9: Agglutination
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Sample Questions
Q1) 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.
Q2) The process by which particulate antigens such as cells aggregate to form larger complexes when specific antibody is present is called:
A) sensitization
B) precipitation
C) agglutination
D) flocculation
Q3) A serological test that uses red blood cells coated with exogenous antigens such as bacterial polysaccharides as a method to detect patient antibodies against that exogenous antigen is called:
A) latex agglutination
B) hemagglutination
C) neutralization
D) complement fixation
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Chapter 10: Labeled Immunoassays
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Sample Questions
Q1) Pregnancy testing is based on an early increase in which hormone?
A) human chorionic gonadotropin
B) luteinizing hormone
C) thyroid-stimulating hormone
D) follicle-stimulating hormone
Q2) Which of the following is characteristic of noncompetitive enzyme immunoassays?
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.
Q3) An ELISA assay was performed on a patient's serum sample.What is the relationship of the amount of enzyme activity to the amount of patient analyte measured?
A) directly proportional
B) indirectly proportional
Q4) Components of a competitive immunoassay include all of the following EXCEPT:
A) labeled analyte
B) means of detection of the label
C) solid-phase antibody
D) standard different from the analyte
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Chapter 11: Molecular Techniques
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Sample Questions
Q1) 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.
Q2) Restriction fragment length polymorphisms are characterized by all of the following EXCEPT:
A) Their DNA base sequences are the same.
B) Different DNA bases result in cleavage at different places.
C) They are detected by gel electrophoresis.
D) Different patterns can be used for identification purposes.
Q3) What would be an advantage of using molecular diagnostic techniques in identification of specific HLA antigens instead of serological techniques?
A) less quality control needed
B) more specific
C) more rapid
D) all of the above
E) all except one of the above
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13
Chapter 12: Flow Cytometry and Laboratory Automation
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Sample Questions
Q1) 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
Q2) 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
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) All of the following are characteristic of cold autoimmune hemolytic anemia EXCEPT:
A) The antibody responsible is IgG.
B) It is usually in older patients.
C) The antibody reacts as an anti-I.
D) The reaction is only seen at cold temperatures.
Q2) Complement is responsible for tissue damage in which of the following reactions?
A) immediate hypersensitivity
B) cytotoxic reactions
C) delayed hypersensitivity
D) anaphylaxis
Q3) An example of a type III hypersensitivity is:
A) myasthenia gravis
B) allergic rhinitis
C) contact sensitivity
D) rheumatoid arthritis
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Chapter 14: Autoimmunity
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Sample Questions
Q1) A 54-year-old woman presents to her optometrist complaining that she has been having difficulty focusing on objects,both near and far.Her vision problems are getting progressively worse.She also thinks that her eyelids are drooping and she is thinking of getting plastic surgery to "put them back up." The optometrist cannot find a good reason for her vision problems but is able to fit her with glasses and recommends that she see a rheumatologist.The rheumatologist sends the women's blood for autoantibody testing,and the laboratory professionals report that the woman has autoantibodies against the acetylcholine receptor.This woman has:
A) myasthenia gravis
B) Goodpasture's syndrome
C) Addison's disease
D) multiple sclerosis
Q2) The fluorescent antinuclear antibody test for lupus is an example of which of the following?
A) competitive immunoassay
B) immunofixation
C) indirect fluorescent testing
D) direct fluorescent testing
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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) Which best describes the difference between chronic and acute lymphocytic leukemias?
A) Chronic lymphocytic leukemias are exclusive of T-cell origin.
B) Acute lymphocytic leukemias have a high response rate to chemotherapy.
C) Chronic lymphocytic leukemias have a shorter survival time.
D) Acute lymphocytic leukemias progress more slowly.
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17
Chapter 16: Immunodeficiency Disease
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Sample Questions
Q1) A nitro-blue tetrazolium (NBT)test indicates little color in cells observed under a microscope.What disease does this most likely indicate?
A) chronic granulomatous disease
B) ataxia-telangiectasia
C) Wiskott-Aldrich syndrome
D) transient hypogammaglobulinemia
Q2) Which of the following is associated with DiGeorge syndrome?
A) small or missing thymus
B) missing B-cell precursors
C) inherited as X-linked recessive
D) M spike in the gamma region
Q3) A 9-month-old infant is seen by a physician due to a persistent skin infection.His white and red blood cell counts are normal.However,immunofixation electrophoresis indicates a low level of IgG.When the infant returns to the physician for a follow-up visit in a month,his IgG level has increased.What condition do these results indicate?
A) SCID
B) transient hypogammaglobulinemia
C) common variable immunodeficiency
D) DiGeorge anomaly
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Page 18
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) 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
Q3) 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
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Page 19
Chapter 19: Tumor Immunology
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Sample Questions
Q1) An ASO test was performed on the serum from a 10-year-old female patient with the following results: no hemolysis in the 1:10,1:20,1:40,and 1:80 tubes; and hemolysis in the 1:160,1:320,and 1:640 tubes.What conclusion can you draw from these results?
A) The titer is 1:640,and the patient may have glomerulonephritis.
B) The titer is 1:160,and the patient may have rheumatic fever.
C) The titer is 1:80,and the patient is normal.
D) The test is invalid and must be repeated.
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 statements best describes Helicobacter pylori?
A) It is a gram-positive coccus that causes skin infections.
B) It is a gram-negative spiral that causes ulcers.
C) It lacks a cell wall and produces a lot of acid.
D) It can be detected by testing for cold agglutinins.
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Chapter 20: Serologic and Molecular Detection of Bacterial
Infections
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Q1) A 25-year-old pregnant female has serologic testing to determine if she has a toxoplasmosis infection.A low level of both IgM and IgG is found.On repeat testing 2 weeks later,the results are the same.What can be concluded from these results?
A) She has an active infection.
B) The baby will have serious central nervous system damage.
C) She was exposed to toxoplasmosis at some time in the past.
D) She has never been exposed to toxoplasmosis.
Q2) 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.
Q3) In an individual with AIDS,what is the most likely reason for a toxoplasmosis infection that invades the central nervous system?
A) The host produces a lot of antibody.
B) Cysts in the tissue become reactivated.
C) The individual ingests contaminated water.
D) The parasite has acquired new surface proteins.
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Chapter 21: Serologic and Molecular Detection of Bacterial
Infections
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Sample Questions
Q1) A 32-year-old heterosexual male presents to the physician with a 3-day history of multiple skin lesions located all over his body and on his mucous membranes.He hasn't felt well and has a low-grade fever.The patient cuts down trees in Massachusetts for a living.He is single,has had multiple sex partners,and does not use condoms.Here are the results of his laboratory tests: rapid plasma reagin = reactive 1:128; Treponema pallidum-particle agglutination assay = reactive; Borrelia burgdorferi IgM = < 1:8; Rickettsia rickettsii IgM < 1:8.This patient has:
A) primary syphilis
B) secondary syphilis
C) lyme disease
D) Rocky Mountain spotted fever
Q2) A patient is diagnosed with syphilis.Which of the following laboratory tests can be used to monitor the effectiveness of therapy in this patient?
A) RPR
B) MHA-TP
C) C-reactive protein
D) monotest
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Page 22
Chapter 22: Serology of Parasitic and Fungal Infections
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Q1) Which of the following positive antibody tests may be an indication of recent vaccination or early primary infection for rubella in a patient with no clinical symptoms?
A) only IgG positive
B) only IgM positive
C) both IgG and IgA antibodies positive
D) fourfold rise in titer for IgG
Q2) In infectious mononucleosis,which of the following would be detectable earliest in the infection,thereby indicating a current infection?
A) anti-EA-IgG
B) anti-EBNA
C) anti-VCA-IgM
D) anti-VCA-IgG
Q3) 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
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Chapter 23: Spirochete Diseases
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Q1) All of the following body fluids are considered to be possible routes of transmission for HIV even if there is no visible sign of blood EXCEPT:
A) spinal fluid
B) semen
C) urine
D) vaginal secretions
Q2) What is different about the replication cycle of HIV that separates it from many other RNA viruses?
A) Viral RNA is used to make cDNA.
B) Viral RNA replicates itself directly to make new RNA.
C) The virus reproduces only in B cells.
D) Proviral DNA makes new viral particles immediately.
Q3) Viral load testing is of most clinical utility in all of the following situations EXCEPT:
A) initial diagnosis of HIV infection when antibody tests are positive
B) monitoring patients during antiretroviral therapy
C) setting a baseline before antiretroviral therapy has begun
D) investigating a patient's sudden drop in T-cell count
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