Boc

Question 1

35 A 25-year-old woman is seen by a physician because of Raynaud phenomenon, myalgias, ONLY arthralgias and difficulty in swallowing. There is no evidence of renal disease. An ANA titer is 1:5120 with a speckled pattern with mitotic. Which of the following are also likely to be found in this patient?

MLS

a high-level nDNA antibody and a low CHso level

b high-level Sm antibody

high-titer rheumatoid factor

d high-level ribonucleoprotein (RNP) antibody

Answer 1

D

Question 2

30

In primary biliary cirrhosis, which of the following antibodies is seen in high titers?

MLS

ONLY

antimitochondrial

b anti-smooth muscle

canti-DNA

d anti-parietal cell

Answer 2

A

Question 3

29

In chronic active hepatitis, high titers of which of the following antibodies are seen?

antimitochondrial

anti-smooth muscle

c anti-DNA

d anti-parietal cell

Answer 3

B

Question 4

False-positive rheumatoid factor in agglutination and nephelometric methods can be due to elevated levels of:

25

MLS

ONLY

a cryoglobulin

b histidine-rich-glycoprotein

aspartame

C1q

Answer 4

D

Question 5

Autoantibodies in the absence of Sm are found in patients with:

15

MLS

ONLY

a mixed connective tissue disease

systemic lupus erythematosus

Crohn disease

d multiple myeloma

Answer 5

A

Question 6

Systemic lupus erythematosus patients often have which of the following test results?

8

a/high titers of DNA antibody

decreased serum immunoglobulin levels

chigh titers of anti-smooth muscle antibodies

d high titers of antimitochondrial antibody

Answer 6

A

Question 7

4

Sera to be tested for IFA-ANA 6 days after drawing is best stored at:

a room temperature

5°C ±2°C

-70°C in a constant temperature freezer

-20°C in a frost-free self-defrosting freezer

Answer 7

C

Question 8

The enzyme control tube in an ASO hemolytic assay exhibits no cell lysis. What is the most likely explanation for this?

64

a incorrect pH of buffer

b low ionic strength buffer

oxidation of the enzyme

reduction of the enzyme

Answer 8

C

Question 9

The enzyme control tube in an ASO hemolytic assay exhibits no cell lysis. What is the most likely explanation for this?

64

a incorrect pH of buffer

b low ionic strength buffer

oxidation of the enzyme

reduction of the enzyme

Answer 9

C

Question 10

Soluble immune complexes are formed under the condition of:

52

antigen deficiency

b) antigen excess

antibody excess

d complement

Answer 10

B

Question 11

In the indirect immunofluorescence method of antibody detection, the labeled antibody is:

41

human anti-goat immunoglobulin

b rheumatoid factor

c goat anti-human immunoglobulin

d complement

Answer 11

A

Question 12

37 Anti-phospholipid antibodies associated with autoimmune disorders tend to have immunoglobulin (IgG) that belongs to which of the following subclasses?

IgG1 and IgG3

bIgG2 and IgG4

IgG1 and IgG4

d IgG2 and IgG3

Answer 12

B

Question 13

79 A cold agglutinin titer end point is 1:16 after incubating overnight in the refrigerator and remains

1:16 after warming. The best course of action is to:

a report the titer as negative

b report the titer as positive, 1:16

crepeat the titer with a fresh sample

test for antibody specificity

Answer 13

D

Question 14

94 The FTA-ABS test for the serological diagnosis of syphilis is: MLS

ONLY

less sensitive and specific than the VDRL if properly performed

currently recommended for testing cerebrospinal fluid

d preferred over darkfield microscopy for diagnosing primary syphilis

likely to remain positive after adequate antibiotic therapy

Answer 14

D

Question 15

93 In the FTA-ABS test, the presence of a beaded pattern of fluorescence along y the treponeme indicates:

a positive identification of Treponema pallidum b

presumptive diagnosis of active syphilis

presence of nontreponemal antibody (NTA)

d false-positive reaction

Answer 15

D

Question 16

A haptenic determinant will react with:

88 MLS ONLY

a both T cells and antibody b T cells but not antibody

c neither T cells nor antibody

dantibody but not T cells

Answer 16

D

Question 17

86 A VDRL serum sample is heat inactivated, then placed in a refrigerator for overnight storage. Before being tested, the serum must be:

a kept colder than 10°C

b allowed to equilibrate to room temperature

warmed to 37°C

reheated to 56°C for 10 minutes

Answer 17

D

Question 18

B In the cold agglutinin test, the tubes containing the serum and erythrocytes are allowed to stand overnight in the refrigerator, and the results are read the next morning. If a disk of the erythrocytes floats up from the bottom of the tube with only the flick of finger, this is read as a:

4+reaction

b 2+ reaction

c 1+reaction

d negative reaction

Answer 18

A

Question 19

79 A cold agglutinin titer end point is 1:16 after incubating overnight in the refrigerator and remains

1:16 after warming. The best course of action is to:

a report the titer as negative

b report the titer as positive, 1:16

crepeat the titer with a fresh sample

test for antibody specificity

Answer 19

D

Question 20

160 Which of the following activities is associated with C3b?

opsonization

anaphylaxis

c vasoconstriction

d chemotaxis

Answer 20

A

Question 21

158 Which of the following is most likely to activate the alternative pathway of complement activation?

a lipopolysaccharides

bglycoproteins

haptens

IgG complexed with antigen

Answer 21

C

Question 22

143 Immunoglobulin idiotypic diversity is best explained by the theory of:

somatic mutation

bgerm line recombination

antigen induction

d clonal selection

Answer 22

B

Question 23

Which class of immunoglobulin is thought to function as an antigenic receptor site on the surface of immature B lymphocytes?

Answer 23

IgM

Question 24

The area of the immunoglobulin molecule referred to as the hinge region is located between

ONLY which domains?

a VH and Vl

CH1 and CH2

CH2 and CH3

d CH3 and VL

Answer 24

B

Question 25

Antibody idiotype is dictated by the: a constant region of heavy chain b constant region of light chain variable regions of heavy and light chains constant regions of heavy and light chains

Answer 25

C

Question 26

141 Antibodies to which of the following immunoglobulins is known to have produced anaphylactic ONLY reactions following blood transfusion? a. IgA b IgD cIgE d IgG

Answer 26

A

Question 27

133 Antibody class and antibody subclass are determined by major physiochemical differences and antigenic variation found primarily in the: constant region of heavy chain constant region of light chain c variable regions of heavy and light chains d constant regions of heavy and light chains

Answer 27

A

Question 28

134 The ratio of kappa to lambda light chain producing cells in normal individuals is:

Answer 28

2:1

Question 29

The air temperature throughout the serology laboratory is 20°C. How will this affect VDRL and RPR test results? no effect-the acceptable test range is 20°-24°C weaken reactions so that false negatives occur strengthen reactions so that positive titers appear elevated d increase the number of false positives from spontaneous clumping

Answer 29

B

Question 30

171 Goat anti-human IgG heavy chain specific alkaline phosphatase conjugate is a: MLS ONLY monoclonal reagent that reacts with gamma heavy chains b monoclonal reagent that reacts with light chains Polyclonal reagent that reacts with gamma heavy chains polyclonal reagent that reacts with light chains

Answer 30

C

Question 31

165 Which of the following releases histamine and other mediators from basophils? a C3a 5 properdin factor B c Cla d C4

Answer 31

A

Question 32

163 In immunofixation electrophoresis: a the antibody reacts with the antigen and then the complex is electrophoresed the antigen is electrophoresed into an antibody containing gel the antigen is electrophoresed and then monospecific antisera is reacted with it the antigen is electrophoresed, transferred to nitrocellulose and then antibody reacts with it and an EIA is performed

Answer 32

C

Question 33

184 Which of the following is the most common humoral immune deficiency disease? MLS ONLY a Bruton agammaglobulinemia IgG deficiency selective IgA deficiency d Wiskott-Aldrich syndrome

Answer 33

C

Question 34

179 The serological test that can be modified to selectively detect only specific IgM antibody in untreated serum is: MLS ONLY Ouchterlony benzyme immunoassay hemagglutination inhibition d passive hemagglutination

Answer 34

B

Question 35

Immunodeficiency with thrombocytopenia and eczema is often referred to as: MLS ONLY a DiGeorge syndrome b Bruton agammaglobulinemia c ataxia telangiectasia aWiskott-Aldrich syndrome

Answer 35

D

Question 36

The autosomal recessive form of severe combined immunodeficiency disease is also referred to as: Bruton agammaglobulinemia Swiss-type lymphopenic agammaglobulinemia DiGeorge syndrome d Wiskott-Aldrich syndrome

Answer 36

B

Question 37

In hybridoma technology, the desirable fused cell is the: MIS ONLY myeloma-myeloma hybrid myeloma-lymphocyte hybrid lymphocyte-lymphocyte hybrid d lymphocyte-granulocyte hybrid

Answer 37

B

Question 38

Which of the following is the most common humoral immune deficiency disease? a Bruton agammaglobulinemia IgG deficiency selective IgA deficiency d Wiskott-Aldrich syndrome

Answer 38

C

Question 39

Hereditary angioedema is characterized by: decreased activity of C3 decreased activity of C1 esterase inhibitor increased activity of C1 esterase inhibitor d increased activity of C2

Answer 39

B

Question 40

Which of the following has been associated with patients who have homozygous C3 deficiency? a undetectable hemolytic complement activity in the serum b systemic lupus erythematosus no detectable disease d lifelong history of life-threatening infections

Answer 40

D

Question 41

Hereditary deficiency of early complement components (C1, C4 and C2) is associated with: a pneumococcal septicemia bsmall bowel obstruction Dipus erythematosus like syndrome gonococcemia

Answer 41

C

Question 42

Infantile X-linked agammaglobulinemia is referred to as: MLS ONLY Bruton agammaglobulinemia DiGeorge syndrome c Swiss-type agammaglobulinemia d ataxia telangiectasia

Answer 42

A

Question 43

Combined immunodeficiency disease with loss of muscle coordination is referred to as: MLS a DiGeorge syndrome hBruton agammaglobulinemia ataxia telangiectasia Wiskott-Aldrich syndrome

Answer 43

C

Question 44

Which immunologic mechanism is usually involved in bronchial asthma? immediate hypersensitivity antibody mediated cytotoxicity c immune complex d delayed hypersensitivity

Answer 44

A

Question 45

Antihistamines like Benadryl: a depress IgE production b block antigen binding to surface IgE bind histamine block H₁ histamine receptors

Answer 45

D

Question 46

Which of the following is used to detect allergen specific IgE? MLS ONLY a RIST b IEP RAST CRP

Answer 46

C

Question 47

208 A patient with a T-cell deficiency will most likely exhibit: increased immune complex formation increased parasitic infections c decreased IgE-mediated responses d decreased complement levels

Answer 47

B

Question 48

211 The HLA antibodies used in histocompatibility typing have been obtained from which of the following? MLS ONLY multiparous women nonidentical siblings c sheep blood d rabbit serum

Answer 48

A

Question 49

Xcancentrate of lymphocytes can be prepared from peripheral blood by: MLS ONLY density gradient centrifugation b ultracentrifugation c zone electrophoresis d freeze fractionation

Answer 49

A

Question 50

In flow cytometry, labeled cells: a scatter the light and absorb fluorescence Labsorb fluorescence and emit electronic impulses cscatter the light and emit fluorescence d absorb both fluorescence and light

Answer 50

C

Question 51

228 In laser flow cytometry, applying a voltage potential to sample droplets as they stream past the light beam and using charged deflector plates results in: MLS ONLY a an emission of red fluorescence from cells labeled with fluorescein isothiocyanate b an emission of green fluorescence from cells labeled with rhodamine a 90 light scatter related to cell size he separation of cells into subpopulations based on their charge

Answer 51

D

Question 52

Which T-cell malignancy may retain "helper" activity with regard to immunoglobulin synthesis MLS ONLY by B cells? a Hodgkin lymphoma acute lymphocytic leukemia (ALL) Sézary syndrome chronic Iymphocytic leukemia (CLL)

Answer 52

C

Question 53

Cells from a patient with hairy cell leukemia have immunologic and functional features of: MLS ONLY a mast cells and B lymphocytes b B lymphocytes and T lymphocytes granulocytes and monocytes àB lymphocytes and monocytes

Answer 53

D

Question 54

HLA-B8 antigen has been associated with which of the following pairs of diseases? MLS ONLY a ankylosing spondylitis and myasthenia gravis bceliac disease and ankylosing spondylitis myasthenia gravis and celiac disease d Reiter disease and multiple sclerosis

Answer 54

C