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CIULLA-SERO Flashcards

1
Q

Color Plate 21B depicts a monomeric immunoglobulin molecule. The portion of
the molecule indicated by the dotted red
circle and the red arrow is called the
A. Fab fragment
B. Fc fragment
C. Heavy chain
D. Hinge region

A

A. Fab fragment

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2
Q

A hapten is
A. Half of an immunoglobulin molecule
B. A earner molecule for an antigen that
is not antigenic alone
C. An immunoglobulin functional only in
the presence of complement
D. A determinant capable of stimulating
an immune response only when bound
to a carrier

A

D. A determinant capable of stimulating
an immune response only when bound
to a carrier

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3
Q

Which of the following is characteristic of B cells?
A. Phagocytic
B. Participate in antibody-dependent
cellular cytotoxicity (ADCC) reactions
C. Contain surface immunoglobulins
D. Secrete the C5 component of
complement

A

C. Contain surface immunoglobulins

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4
Q

A lymphokine is
A. A soluble mediator produced by granulocytes and affecting lymphocytes
B. A soluble mediator produced by lymphocytes
C. A soluble mediator produced by plasma cells
D. An antibody that reacts with lymphocytes

A

B. A soluble mediator produced by
lymphocytes

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5
Q

Monocytes and macrophages play a major role in the mononuclear phagocytic system. For an antibody-coated antigen to be phagocytized, what part of the antibody molecule fits into a receptor on the phagocytic cell?
A. Fc region
B. Fab region
C. Hinge region
D. Variable region

A

A. Fc region

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6
Q

Cell-mediated immunity is primarily mediated by
A. B cells
B. T helper cells
C. Plasma cells
D. Dendritic cells

A

B. T helper cells

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7
Q

The HLA complex is located primarily on
A. Chromosomes
B. Chromosome 6
C. Chromosome 9
D. Chromosome 17

A

B. Chromosome 6

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8
Q

HLA antigens are found on
A. All nucleated cells
B. Red blood cells only
C. Solid tissue only
D. White blood cells only

A

A. All nucleated cells

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9
Q

Which of the following is more likely to be diagnostic of an acute infection?
A. A total acute antibody liter of 2 followed by a convalescent titer of 16
B. A total acute antibody titer of 80 followed by a convalescent titer of 40
C. A total antibody titer of 80
D. An IgG antibody titer of 80

A

A. A total acute antibody liter of 2 followed by a convalescent titer of 16

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10
Q

A young woman shows increased susceptibility to pyogenic infections. Upon assay, she shows a low level of C3. Which of the following statements is probably true?
A. She has an autoimmune disease with continual antigen-antibody activity causing consumption of C3.
B. She has DiGeorge syndrome.
C. She has decreased production of C3.
D. She may produce an inactive form of C2, a precursor of C3.

A

C. She has decreased production of C3.

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11
Q

What is the predominant type of antibody found in the serum of neonates born after full-term gestation?
A. Infant IgA
B. Infant IgG
C. Infant IgM
D. Maternal IgG

A

D. Maternal IgG

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12
Q

An important part of the nonspecific immune response is(are)
A. B cells
B. Basophils
C. Complement cascade
D. Cytotoxic T lymphocytes

A

C. Complement cascade

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13
Q

The major class of immunoglobulin found in adult human serum is
A. IgA
B. IgE
C. IgG
D. IgM

A

C. IgG

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14
Q

Which class of immunoglobulin possesses delta heavy chains?
A. IgA
B. IgD
C. IgE
D. IgG

A

B. IgD

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15
Q

Which class of immunoglobulin possesses 10 antigenic binding sites?
A. IgA
B. IgD
C. IgG
D. IgM

A

D. IgM

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16
Q

Color Plate 22 * represents a dimeric IgA molecule. The structure printed in red and indicated by the red arrow is called the
A. J-piece
B. Hinge region
C. Heavy chain
D. Light chain

A

A. J-piece

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17
Q

Which class of immunoglobulin binds to basophils and mast cells to mediate immediate hypersensitivity reactions?
A. IgA
B. IgD
C. IgE
D. IgG

A

C. IgE

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18
Q

Type I hypersensitivity is
A. Associated with complement-mediated cell lysis
B. Due to immune complex deposition
C. Mediated by activated macrophages
D. An immediate allergic reaction

A

D. An immediate allergic reaction

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19
Q

When performing the enzyme-multiplied immunoassay technique (EMIT), how is the ligand in the patient’s serum detected?
A. Agglutinates by binding to antibody-coated latex beads
B. Binds to enzyme-labeled antibody
C. Competes with enzyme-labeled antigen for binding to a specific antibody
D. Forms antibody-antigen complex and precipitates

A

C. Competes with enzyme-labeled antigen for binding to a specific antibody

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20
Q

Severe combined immunodeficiency (SCID) is an
A. Immunodeficiency with decreased B cells and neutrophils
B. Immunodeficiency with lymphocytopenia and eosinophilia
C. Immunodeficiency with decreased or dysfunctional T and B cells
D. Immunodeficiency with decreased lymphocytes and decreased complement concentration

A

C. Immunodeficiency with decreased or dysfunctional T and B cells

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21
Q

An example of immune injury due to the
deposition of antigen-antibody complexes is
A. Acute glomerulonephritis
B. Bee-sting allergy
C. Contact dermatitis
D. Penicillin allergy

A

A. Acute glomerulonephritis

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22
Q

The serologically detectable antibody
produced in rheumatoid arthritis (RA) is
primarily of the class
A. IgA
B. IgE
C. IgG
D. IgM

A

D. IgM

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23
Q

In bone marrow transplantation, immunocompetent cells in the donor marrow may recognize antigens in the recipient and
respond to those antigens. This phenomenon is an example of
A. Acute rejection
B. Chronic rejection
C. Graft versus host disease
D. Hyperacute rejection

A

C. Graft versus host disease

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24
Q

Multiple myeloma is a
A. Lymphoproliferative disease of T cells
B. Cancer of plasma cells characterized by increased antibody concentration
C. Lymphoproliferative disease resulting
in a decrease in antibody production
D. Cancer of monocytes characterized by
increased kappa and lambda chain
synthesis

A

B. Cancer of plasma cells characterized by increased antibody concentration

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25
Q

Which one of the following describes a
direct immunofluorescence assay?
A. Conjugated reagent antigen reacts with
antibodies to form antigen-antibody
complexes
B. Antigens react with unlabeled
antibody forming antigen-antibody
complexes that attach to labeled
antibodies
C. A dye is attached to a molecule and it
reacts with an immune complex to
produce a color
D. Conjugated reagent antibody reacts with antigen to form antigen-antibody complexes

A

D. Conjugated reagent antibody reacts with antigen to form antigen-antibody complexes

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26
Q

In individuals allergic to pollen, hyposensitization protocols may be initiated.
These individuals receive injections of
A. Allergen
B. Pooled human antisera
C. Monoclonal antibody directed against human T cells
D. Monoclonal antibody directed against human B cells

A

A. Allergen

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27
Q

After exposure to antigen, the first
antibodies that can be detected belong to
the class
A. IgA
B. IgE
C. IgG
D. IgM

A

D. IgM

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28
Q

Corneal tissue may be transplanted
successfully from one patient to another
because
A. The cornea is nonantigenic
B. Cornea! antigens do not activate T cells
C. Anticorneal antibodies are easily
suppressed
D. The cornea occupies a privileged site
not usually seen by the immune system

A

D. The cornea occupies a privileged site
not usually seen by the immune system

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29
Q

A kidney transplant from one identical
twin to another is an example of a(n)
A. Allograft
B. Autograft
C. Isograft
D. Xenograft

A

C. Isograft

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30
Q

In Bruton disease, measurement of serum
immunoglobulins would show
A. Elevated levels of IgE
B. Elevated levels of IgG
C. Normal levels of IgG and IgM but
reduced levels of IgA
D. The absence of all immunoglobulins

A

D. The absence of all immunoglobulins

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31
Q

Diagnosis of group A streptococci
(Streptococcus pyogenes) infection is
indicated by the presence of
A. Anti-protein A
B. Anti-DNaseB
C. Anti-beta-toxin
D. C-reactive protein

A

B. Anti-DNaseB

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32
Q

A molecule found in human serum
sometimes used as a tumor marker is
A. a-Fetoprotein
B. HBsAg
C. Biotin
D. GDI

A

A. a-Fetoprotein

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33
Q

Which cell is the principal source of
interleukin 2?
A. B-cell
B. T-cell
C. Monocyte
D. Plasma cell

A

B. T-cell

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34
Q

Diagnostic reagents useful for detecting
antigen by the coagglutination reaction
may be prepared by binding antibody to
killed staphylococcal cells via the Fc
receptor of staphylococcal protein A. The
class of antibody bound by this protein is
A. IgA
B. IgD
C. IgG
D. IgM

A

C. IgG

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35
Q

A major advantage of passive immunization
compared to active immunization is that
A. Antibody is available more quickly
B. Antibody persists for the life of the
recipient
C. IgM is the predominant antibody class
provided
D. Oral administration can be used

A

A. Antibody is available more quickly

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36
Q

The strength with which a multivalent
antibody binds a multivalent antigen is
termed the
A. Affinity
B. Avidity
C. Reactivity
D. Valence

A

B. Avidity

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37
Q

How does the secondary humoral immune
response differ from the primary
response?
A. The lag phase (the time between
exposure to immunogen and production of antibody) is longer in the
secondary immune response.
B. IgM is the predominant antibody class
produced in the secondary immune
response.
C. The antibody levels produced are
higher in the secondary immune
response.
D. Cytotoxic T lymphocytes play an
important role in the secondary
response.

A

C. The antibody levels produced are
higher in the secondary immune
response.

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38
Q

After activation of the complement
system, leukocytes and macrophages are
attracted to the site of complement
activation by
A. Cl
B. C5a
C. C8
D. IgM

A

B. C5a

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39
Q

The type of immunity that follows the
injection of an immunogen is termed
A. Artificial active
B. Natural active
C. Artificial passive
D. Innate

A

A. Artificial active

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40
Q

The type of immunity that follows the
injection of antibodies synthesized by
another individual or animal is termed
A. Artificial active
B. Natural adaptive
C. Artificial passive
D. Natural passive

A

C. Artificial passive

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41
Q

Innate immunity includes
A. Anamnestic response
B. Antibody production
C. Cytotoxic T cell activity
D. Phagocytosis by polymorphonuclear cells

A

D. Phagocytosis by polymorphonuclear cells

42
Q

The agglutination pattern shown in Color
Plate 23 * was observed while performing
an antibody titration. This agglutination
pattern is an example of
A. A prezone reaction
B. A prozone reaction
C. A postzone reaction
D. Incomplete complement inactivation

A

B. A prozone reaction

43
Q

The antibody most frequently present in
systemic lupus erythematosus is directed
against
A. Surface antigens of bone marrow
stem cells
B. Surface antigens of renal cells
C. Nuclear antigen
D. Myelin

A

C. Nuclear antigen

44
Q

The rapid plasma reagin assay for syphilis
does not need to be read microscopically
because the antigen is
A. Cardiolipin
B. Complexed with latex
C. Complexed with charcoal
D. Inactivated bacterial cells

A

C. Complexed with charcoal

45
Q

The Venereal Disease Research Laboratory
(VDRL) test for syphilis is classified as a(n)
A. Agglutination reaction
B. Flocculation reaction
C. Hemagglutination reaction
D. Precipitation reaction

A

B. Flocculation reaction

46
Q

One cause of a false-positive VDRL test is
A. Brucellosis
B. Treponema pallidum infection
C. Rocky Mountain spotted fever
D. Systemic lupus erythematosus

A

D. Systemic lupus erythematosus

47
Q

The portion of an antigen that binds to an
antibody or T cell receptor is called a(n)
A. Allergin
B. Avidin
C. Epitope
D. Valence

A

C. Epitope

48
Q

Identical antibodies produced from a
single clone of plasma cells describes
A. Reagin
B. Cold agglutinins
C. Heterophile antibodies
D. Monoclonal antibodies

A

D. Monoclonal antibodies

49
Q

IgM antibodies react well in complement
fixation (CF) tests. Because of this, CF
tests for antibodies should
A. Be positive early in the course of the
disease
B. Be useful in identifying antibodies
responsible for a delayed hypersensitivity reaction
C. Be useful in identifying antibodies
responsible for anaphylactic reactions
D. Detect transplacental antibodies

A

A. Be positive early in the course of the
disease

50
Q

Which of the following serologic tests is
commonly performed by an immunofluorescence method?
A. Anti-HBs
B. Antinuclear antibody (ANA)
C. Antistreptolysin O (ASO)
D. C-reactive protein (CRP)

A

B. Antinuclear antibody (ANA)

51
Q

The Fab portion of an antibody
A. Binds T cell receptor
B. Consists of two light chains only
C. Consists of two heavy chains only
D. Contains the hypervariable region

A

D. Contains the hypervariable region

52
Q

In the enzyme-linked immunosorbent
assay (ELISA), the visible reaction is due
to a reaction between
A. Enzyme and antibody
B. Enzyme and substrate
C. Fluorescent dye and antigen
D. Latex particles and antibody

A

B. Enzyme and substrate

53
Q

Elevated IgE levels are typically found in
A. Type I hypersensitivity reactions
B. Type II hypersensitivity reactions
C. Type III hypersensitivity reactions
D. Type IV hypersensitivity reactions

A

A. Type I hypersensitivity reactions

54
Q

Loss of self-tolerance results in
A. Autoimmune disease
B. Graft-versus-host disease
C. Immunodeficiency
D. Tumors

A

A. Autoimmune disease

55
Q

A human cell with CDS on its surface is most likely a
A. B-cell
B. Monocyte
C. T helper cell
D. Cytotoxic T cell

A

D. Cytotoxic T cell

56
Q

Which of the following statements about
immunoglobulin light chains is true ?
A. Each immunoglobulin monomer has
either one kappa or one lambda chain.
B. There are two types: kappa and
lambda.
C. They consist of constant regions only.
D. They form part of the Fc fragment.

A

B. There are two types: kappa and
lambda.

57
Q

Which of the following statements applies
to the Fc fragment of an immunoglobulin
molecule?
A. It consists of the entire heavy chain.
B. It contains the variable region of the
heavy chain.
C. It contains the antigen binding sites of
the molecule.
D. It is the region of the molecule that
binds to receptors on various white
blood cells.

A

D. It is the region of the molecule that
binds to receptors on various white
blood cells.

58
Q

Monoclonal antibodies are produced by
A. Cultured T cells
B. Human plasma cells
C. Mouse plasma cells
D. Hybridomas

A

D. Hybridomas

59
Q

Antibodies that bind to the same epitope
are of the same
A. Allotype
B. Autotype
C. Idiotype
D. Isotype

A

C. Idiotype

60
Q

Skin testing is a useful diagnostic tool in a number of disorders, such as tuberculosis. Which of the following statements about skin testing is true?
A. A positive test depends on preformed
antibody.
B. Reactivity to a particular antigen may
be transferred from one individual to
another by sensitized lymphocytes.
C. The intensity of the response correlates directly with the clinical activity
of the disease.
D. The maximum response will occur
immediately.

A

B. Reactivity to a particular antigen may
be transferred from one individual to
another by sensitized lymphocytes.

61
Q

The activity of natural killer (NK) cells
A. Does not require previous exposure to
an antigen
B. Involves phagocytosis and killing of
bacteria
C. Requires interaction with cytotoxic
T cells
D. Requires interaction with B cells

A

A. Does not require previous exposure to
an antigen

62
Q

Interaction between B and T helper cells
involves
A. MHC II molecule on B cell binding to
MHCI molecule on the T cell
B. MHC II molecule on B cell binding to
CDS on the T cell
C. Foreign antigen on B cell binding to
T cell receptor
D. CDS molecule on B cell binding to
T cell receptor

A

C. Foreign antigen on B cell binding to
T cell receptor

63
Q

Which of the following is a characteristic
of T cells?
A. Synthesize antibody
B. Mature in the thymus
C. Able to bind unprocessed antigen
D. Primarily protect against extracellular
parasites

A

B. Mature in the thymus

64
Q

The primary mechanism responsible
for pathology in SLE is
A. Allergic reaction to foreign molecules
B. Antibodies directed against self antigens
C. Polyclonal activation of cytotoxic
T cells
D. Lack of intracellular killing after
neutrophil phagocytosis of bacteria

A

B. Antibodies directed against self antigens

65
Q

Which complement protein is present in
the greatest concentration in human
serum?
A. Cl
B. C2
C. C3
D. C4

A

C. C3

66
Q

An autoimmune disease causing destruction of pancreatic cells can result in
A. Hashimoto disease
B. Multiple sclerosis
C. My asthenia gravis
D. Type 1 diabetes

A

D. Type 1 diabetes

67
Q

An Ouchterlony gel diffusion plate is
depicted in Color Plate 24B. The center
well contains antibody, and the peripheral
wells contain antigens labeled 1 through 4.
What is the relationship between the
antigens in wells 2 and 3?
A. 2 is part of 3.
B. 3 is part of 2.
C. They are identical.
D. They are unrelated.

A

D. They are unrelated.

68
Q

An Ouchterlony gel diffusion plate is
depicted in Color Plate 24B. The center well
contains antibody, and the peripheral wells
contain antigens labeled 1 through 4. What
is the relationship between the antigens in
wells 2 and 4?
A. Cannot be determined.
B. They are identical.
C. They are unrelated.
D. They react incompletely with the antibody

A

B. They are identical.

69
Q

Which of the following complement
proteins is part of the membrane attack
complex?
A. Cl
B. C3
C. C4
D. C5

A

D. C5

70
Q

Which of the following is characteristic of
contact hypersensitivity reactions?
A. Caused by preformed IgE antibody
B. Characterized by infiltration of
neutrophils into the area of reaction
C. The primary symptoms often occur in
the respiratory tract.
D. Usually due to a hapten

A

D. Usually due to a hapten

71
Q

Which of the following statements about the
test for C-reactive protein (CRP) is true?
A. It correlates with neutrophil phagocytic function.
B. It is an indicator of ongoing inflammation.
C. It is diagnostic for rheumatic fever.
D. Levels decrease during heart disease.

A

B. It is an indicator of ongoing inflammation.

72
Q

In the classical pathway of complement
activation,
A. C3 is activated by binding C-reactive
protein
B. The sequence of activation is Cl, C2,
C3,C4
C. Clq is activated by the presence of
a single Fab region
D. Activation by antibody requires one
IgM or two IgG molecules

A

D. Activation by antibody requires one
IgM or two IgG molecules

73
Q

The alternative complement pathway
A. Can be activated by bacterial capsule polysaccharides
B. Uses C5b as a C3 convertase
C. Bypasses steps C3 through C5
D. Is inactivated by properdin

A

A. Can be activated by bacterial capsule polysaccharides

74
Q

A cut on a person’s finger becomes
contaminated with the bacterium
Staphylococcus aureus. The first
response by the immune system
consists of activity of
A. B cells
B. Monocytes
C. Neutrophils
D. T cells

A

C. Neutrophils

75
Q

Incompatible blood transfusions are
examples of
A. Type I hypersensitivity reactions
B. Type II hypersensitivity reactions
C. Type III hypersensitivity reactions
D. Type IV hypersensitivity reactions

A

B. Type II hypersensitivity reactions

76
Q

A soluble antigen and soluble antibody
reacting to form an insoluble product
describes
A. Agglutination reactions
B. Heterophile reactions
C. Labeled reactions
D. Precipitation reactions

A

D. Precipitation reactions

77
Q

Which of the following is an example of a
treponemal antigen test used for the
diagnosis of syphilis?
A. CRP
B. RPR
C. VDRL
D. FTA-ABS

A

D. FTA-ABS

78
Q

A serum sample is positive for HBsAg.
This result indicates that the person from
whom the serum was taken
A. Had a hepatitis B infection in the past
but overcame the infection
B. Has either active or chronic hepatitis B infection
C. Was immunized recently against the
hepatitis B virus
D. Is not infectious for the hepatitis B
virus

A

B. Has either active or chronic hepatitis B infection

79
Q

What is the indicator system used in the
complement fixation test?
A. Sensitized sheep red blood cells
B. Fluorescent-labeled antihuman
globulin
C. Enzyme-labeled antihuman globulin
D. Guinea pig complement

A

A. Sensitized sheep red blood cells

80
Q

The isotype of an immunoglobulin
antibody
A. Is defined by the heavy chain
B. Is defined as different alleles of the
same antibody type (e.g., IgG)
C. Is constant for all immunoglobulins of
an individual
D. Is the variation within the variable
region

A

A. Is defined by the heavy chain

81
Q

A patient report states the presence of
serum antibodies to OspC. What disease
does the patient most likely have?
A. Syphilis
B. Strep throat
C. Lyme disease
D. Rubella

A

C. Lyme disease

82
Q

Patient serum is mixed with a suspension
of guinea pig antigen. When the sample is
then mixed with horse red blood cells,
agglutination occurs. This is suggestive
of an infection caused by
A. Borrelia burgdorferi
B. Hepatitis B virus
C. Hepatitis C virus
D. Epstein-Barr virus

A

D. Epstein-Barr virus

83
Q

Hashimoto disease is an autoimmune
disease primarily involving the
A. Kidneys
B. Liver
C. Lungs
D. Thyroid gland

A

D. Thyroid gland

84
Q

Rheumatic fever sometimes occurs after
group A streptococcal infections. In this
condition, an autoimmune response
attacks the tissue of the heart valves. This
phenomenon is an example of
A. Epitope spreading
B. Molecular mimicry
C. Polyclonal B cell activation
D. Preferential activation of T helper cells

A

B. Molecular mimicry

85
Q

“Superantigens” are toxins produced by
some strains of Staphylococcus aureus
and group A streptococci and cause
damage by
A. Molecular mimicry
B. Polyclonal T cell activation
C. Lysing white blood cells and platelets
D. Lysing red blood cells

A

B. Polyclonal T cell activation

86
Q

The first serologic marker to appear in
patients with acute hepatitis B virus
infection is
A. Anti-HB
B. Anti-HBc
C. Anti-HBe
D. HBsAg

A

D. HBsAg

87
Q

A living donor is being sought for a child
who requires a kidney transplant. The best
odds of finding an MHC-compatible
donor occur between the child and
A. A sibling (brother or sister)
B. An unrelated individual
C. The child’s father
D. The child’s mother

A

A. A sibling (brother or sister)

88
Q

Cells that can act as antigen-presenting
cells for exogenous antigens include
A. All nucleated cells
B. Endothelial cells
C. B lymphocytes
D. T lymphocytes

A

C. B lymphocytes

89
Q

In patients with human immunodeficiency
virus infection, immune status can be
monitored by measuring the ratio of
A. CD3+ cells to CD8+ cells
B. CD4+ cells to CD8+ cells
C. Lymphocytes to monocytes
D. T cells to B cells

A

B. CD4+ cells to CD8+ cells

90
Q

Why does vaccination against hepatitis B
virus (HBV) also prevent hepatitis D virus
(HDV) infections?
A. An immunogen from HBV in the
vaccine is also associated with HDV.
B. The HBV vaccine induces formation
of heterophile antibodies that cross
react with HDV.
C. The HBV vaccine stimulates liver cells
to produce antiviral molecules active
against all hepatitis viruses.
D. HDV requires the host to be concurrently infected with HBV.

A

D. HDV requires the host to be concurrently infected with HBV.

91
Q

B lymphocytes and T lymphocytes are
derived from
A. Hematopoietic stem cells
B. Macrophages or monocytes
C. Mucosa-associated lymphoid tissue
D. The fetal liver

A

A. Hematopoietic stem cells

92
Q

Contact dermatitis is mediated by
A. B lymphocytes
B. T lymphocytes
C. Macrophages
D. Polymorphonuclear cells

A

B. T lymphocytes

93
Q

In a competitive radioimnumosorbent test
(RIST), what does a high signal suggest?
A. The patient sample has a low concentration of IgE.
B. The patient sample has a low concentration of IgM.
C. The patient sample has a high concentration of IgE.
D. The patient sample has a high concentration of total antibody

A

A. The patient sample has a low concentration of IgE.

94
Q

An antibody titration is depicted in Color
Plate 25 *. In this titration, a 0.2 mL aliquot
of a patient’s serum sample was added to
0.8 mL of saline, and this mixture was
placed into tube #1. A 0.5 mL sample was
removed from tube #1 and placed into
tube #2, containing 0.5 mL of saline. This
procedure was repeated through tube #10.
The dilutions were assayed for antibody to
an infectious agent. How should the
antibody titer be reported?
A. 256
B. 512
C. 640
D. 1280

A

C. 640

95
Q

In a chemiluminescent immunologic
assay, what is the signal detected?
A. Light
B. An electric signal
C. A purple-colored compound
D. A yellow-colored compound

A

A. Light

96
Q

A 28-year-old female complains to her
family physician of abdominal pain, loss
of appetite, and low-grade fever. Physical
examination reveals abdominal tenderness
and a low-grade fever. Her physician
orders a hepatitis profile and obtains the
results below.
Anti-HAV - nonreactive
Anti-HBc - reactive
Anti-HBs - nonreactive
HBsAg - reactive
HBeAg - reactive
Anti-HCV - nonreactive

Which of the following is the most likely
conclusion?
A. Acute HAV infection
B. Acute HBV infection
C. Chronic HBV infection
D. Immunity to HBV due to past
infection

A

C. Chronic HBV infection

97
Q

An 11-year-old female presents with fever,
sore throat, lethargy, and tender cervical
lymphadenopathy. Relevant findings include
splenomegaly and lymphocytosis, with
many large reactive (atypical) lymphocytes.
A heterophile antibody test was negative.
Further laboratory results were as follows:
CMV - IgG titer = 20; IgM titer = 0
EBV VGA - IgG titer = 0; IgM titer = 80
Mono spot - IgG titer = 0; IgM titer = 0

What conclusion can be made concerning
the diagnosis?
A. Acute CMV infection
B. Acute EBV infection
C. Chronic CMV infection
D. Chronic EBV infection

A

B. Acute EBV infection

98
Q

A male infant had been well until about 5
months of age, at which time he was
diagnosed as having otitis media and
bronchitis caused by Haemophilus
influenzae. Over the next several months he
presented with streptococcal pneumonia
several times. At 10 months of age a serum
protein electrophoresis showed a virtual lack
of gamma globulins. Quantitative serum
levels were as follows: 75 mg/dL IgG and
undetectable levels of IgM, IgA, and IgE.
There were a normal number of T cells, and
they exhibited normal mitogen stimulation.
What disease does this child most likely
suffer from?
A. Combined immunodeficiency
B. DiGeorge syndrome
C. latrogenic immunodeficiency
D. X-linked agammaglobulinemia

A

D. X-linked agammaglobulinemia

99
Q

A 25-year-old male presents to his family
physician complaining of fatigue, diarrhea,
and weight loss of a few months duration.
On physical examination the patient is
found to have a fever and abdominal
discomfort. Laboratory results indicate a
white blood cell count of 14.3 X 109/L
(reference range 4.8-10.8 X 109/L).
Assays for HBSAg and anti-HCV are
negative. An ELISA test for antibodies to
the human immunodeficiency virus (HIV)
performed on the patient’s serum is found to
be reactive. What step should be taken next?
A. Call the physician with the HIV result.
B. Repeat the HIV ELISA test on the sample.
C. Test the patient’s serum for anti-HBs.
D. Contact the patient to collect a second
sample

A

B. Repeat the HIV ELISA test on the sample.

100
Q

A 38-year-old woman visited her
physician because of fatigue, fever, and
joint pain (proximal interphalangeal,
wrist, and knee joints). She also noticed
sensitivity to the sun and reported having a
rash following recent exposure. The
physician noted a rash over her nose and
cheeks. Laboratory results included white
blood cell count 5.5 X 109/L (reference
range 4.8-10.8 X 109/L) and red blood
cell count 4.5 X 1012/L (reference range
4.0-5.4 X 1012/L). Urinalysis results
were within reference ranges, except for
4+ protein and 1+ RBCs, 0-3 hyaline
casts/lpf and 0-1 RBC cast/lpf on
microscopic examination. Which of the
following tests would be most helpful in
diagnosing this patient’s condition?
A. Anti-nuclear antibody
B. a-Fetoprotein
C. Anti-streptolysin O
D. Hepatitis profile

A

A. Anti-nuclear antibody

MTAP 1 (13 decks)

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