Immuno Final Flashcards
(131 cards)
1
Q
Lupis Erythematosus is best diagnosed by
A
antinuclear antibodies
2
Q
Sera tested for IFA-ANA is best stored at what temperature?
A
5°C ± 2°C
3
Q
Rim patern in the IFA-ANA test is most commonly associated with what
A
antibodies directed at native DNA
4
Q
If a technologist observes a homogenous staining of the nucleus of interphase cells during an IFA-ANA test, combined with chromosome staining of the mitotic cells, this result is?
A
Expected of anti-DNA antibodies
5
Q
An anti-dsDNA titer 1:80 and a higher titer of antibodies to Sm are best correlated with
A
an anti-nuclear antibody test with a titer of 1:320 for a peripheral pattern
6
Q
High titers of DNA antibody are common test realists in what patients?
A
systemic lupus erythematosus
7
Q
If a patient has these test results: ANA- +1:320, ASO- Todd Units, Complement- Decreased, RA- +,
What does the patient have?
A
lupus erythematosus
8
Q
Nephelometry is
A
the most sensitive and appropriate method for the derection of rheumatoid factor
9
Q
Gamma globulin-coated particles can react with
A
the rheumatoid factor
10
Q
Consistent and repetitive negative IFA-ANA is a sign of what
A
Strong evidence against untreated SLE
11
Q
Hyperglobulinemia is associated with
A
positive rheumatoid factor
12
Q
A positive test for the detection of IgM class antibodies may be false when
A
rheumatoid factor is present in a patient’s serum
13
Q
Autoantibodies with the specificity for the Fc portion of the immunoglobulin (IgG) molecule is the definition of?
A
Rheumatoid factor
14
Q
Thyroid disease most often results in high titers of what?
A
antimicrosomal antibodies
15
Q
High titers of anti-smooth muscle are seen in
A
chronic active hepatitis
16
Q
Nucleolar immunofluorescent patterns are seen in individuals that have
A
anti-RNA antibodies
17
Q
Speckled immunofluorescent patterns are often associated with what?
A
Anti-extractable nuclear antigens
18
Q
When given an anti-nuclear antibody indirect immunofluorescent test, a patient exhibits a positive speckled pattern. What other test is necessary to perform?
A
Screen for Sm and RNP antibodies
19
Q
Goat anti-human immunoglobulin is an antibody that…
A
has an indirect immunofluoresecent method of antibody detection in patient serum.
20
Q
Antigen-antibody reactions are the same as what?
A
Chemical reactions
21
Q
Fluorescein isothiocyanate is a common label for
A
direct fluorescent antibody technique (DFA)
22
Q
Describe the Indirect fluorescence procedure
A
a substrate is first exposed into a patient’s serum and then after washing an anti-human immunoglobulin labeled with fluorochrome is added
23
Q
Strength of a reacting antbody is the definition for?
A
Avidity
24
Q
A rise in titer of the patient’s serum is most important in
A
the interpretation of agglutination tests for febrile diseases.
25
To increase sensitivity of the antigen, what is added in flocculation tests for Syphilis?
cholesterol.
26
Avidity is defined as
the strength of a visible reaction
27
When precipitin lines cross and form a double spur, what type of antigen-antibody precipitation reaction is identified?
reaction of non-identity
28
The test that has the highest sensitivity for antigen detection is?
ELISA
29
When excess antigen is present in precipitation gel reactions, what is expected to happen to the gel?
it will dissolve the precipitate after formation
30
The condition of antigen excess is formed under what complexes?
soluble immune complexes
31
Precipitation is described as
the visible serological reaction between soluble antigen and its specific antibody.
32
The enzyme control tube in an ASO hemolytic assay exhibits no cell lysis. What is the most likely
explanation for this?
oxidation of the enzyme
33
In a positive anti-streptolysin "0" enzyme inhibition test, the patient's:
anti-streptolysin "0" inhibits the reagent streptolysin "O"'s, resulting in no hemolysis
34
Blood is drawn from a patient for serological tests for a viral disease at the time of onset and again
4 weeks later. The results of the tests are considered diagnostic if the:
second antibody titer is at least 4x the first
35
Which of the following is most useful in establishing a diagnosis in the convalescence phase of
a viral infection?
serological techniques
36
The best method to detect infections due to rubella, Epstein-Barr and human immunodeficiency
viruses is:
antibody detection by EIA
37
Immunoassays are based on the principle of:
antibody recognition of homologous antigen
38
A DPT vaccination is an example of:
active humoral-mediated immunity
39
Cells known to be actively phagocytic include:
neutrophils, eosinophils, monocytes
40
The presence of HbsAg, anti-HBc and often HbeAg is characteristic of:
early acute phase HBV hepatitis
41
When testing a patient for HIV antibody, which of the following is used to confirm a positive
screening test?
Western blot
42
What kind of antigen-antibody reaction would be expected if soluble antigen is added to
homologous antibody?
precipitation
43
The Rapid Plasma Reagin test:
is useful in screening for syphilis
44
Flocculation tests for syphilis detect the presence of:
reagin antibody
45
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
46
Flocculation tests for syphilis use antigen composed of:
cardiolipin and lecithin
47
A VDRL serum sample is heat inactivated, then placed in a refrigerator for overnight storage.
Before being tested, the serum must be:
reheated to 56°C for 10 minutes
48
Substancesthat are antigenic only when coupled to a protein carrier are:
haptens
49
.A serological test for syphilis that depends upon the detection of cardiolipin-lecithin-cholesterol antigen is:
RPR
50
The serological test for syphilis recommended for detecting antibody in cerebrospinal fluid is:
a nontreponemal antibody
CSF-VDRL
51
What assay would confirm the immune status to hepatitis B virus?
anti-HBs
52
The following procedure has been routinely used for detection of hepatitis B surface antigen (HBsAg) because of its high level of sensitivity:
ELISA
53
In an indirect ELISA method designed to detect antibody to the rubella virus in patient serum, the conjugate used should be:
anti-human IgG conjugated to an enzyme
54
Which of the following is the best indicator of an acute infection with the hepatitis A virus?
the presence of IgM antibodies to hepatitis A virus
55
Biological false-positive VDRL reactions are frequently encountered in patients with:
lupus erythematosus
56
Which serological marker of HBV (hepatitis B virus) infection indicates recovery immunity?
anti-HBs
57
For diagnosis of late latent or tertiary syphilis, the most appropriate assay is:
FTA-ABS
58
A 26-year-old nurse developed fatigue, a low-grade fever, polyarthritis and urticaria. Two months earlier she had cared for a patient with hepatitis. Which of the following findings are likely to be observed in this nurse?
elevated AST and ALT levels
59
The classic antibody response pattern following infection with hepatitis A is:
increase in IgM antibody; decrease in IgM antibody; increase in IgG antibody
60
The enzyme-linked immunosorbent assay (ELISA) technique for the detection of HBsAg:
uses anti-HBs linked to horseradish peroxidase
61
The antigen marker most closely associated with transmissibility of HBV infection is:
HBeAg
62
Chronic carriers ofHBV:
continue to carryHBV
63
The initial immune response following fetal infection with rubeEa is the production of which class(es) of antibodies?
IgM
64
A maternal serum rubella titer that is equal to or greater than 1:8 indicates:
probable immunity to rubella
65
Which of the following is a treponemal test?
FTA-ABS
66
The air temperature throughout the serology laboratory is 20°C. How will this affect VDRL and RPR test results?
weaken reactions so that false negatives occur
67
Which laboratory technique is most frequently used to diagnose and follow the course of therapy of a patient with secondary syphilis?
flocculation
68
The most commonly used serological indicator of recent streptococcal infection is the antibody to:
streptolysin O
69
Antibodies composed of IgG immunoglobulin:
can cross the placenta from mother to fetus
70
Measurement of serum levels of which of the following immunoglobulins can serve as a screening
test for multiple allergies?
a IgA b IgE c IgG d IgM
Cells that are precursors of plasma cells and also produce immunoglobulins are:
B lymphocytes
71
IgM antibodies are frequently hemolytic because of:
their efficient ability to fix complement
72
To which of the following classes do the antibodies that cause hemolytic disease of the newborn belong?
IgG
73
It is important to note that when an infant is born, levels of specific antibody of the following class are used to indicate neonatal infection:
IgG
74
Antibodies are produced by:
B cells
75
Antibody class and antibody subclass are determined by major physiochemical differences and antigenic variation found primarily in the:
constant region of heavy chain
76
Which of the following immunoglobulin classes is associated with a secretory component (transport piece)?
IgA
77
The immunoglobulin class typically found to be present in saliva, tears and other secretions is
IgA
78
Treatment of IgG with papain results in how many fragments from each immunoglobulin molecule?
3
79
The immunoglobulin class associated with immediate hypersensitivity or atopic reactions is:
IgE
80
Which of the following immunoglobulins is the most efficient at agglutination?
IgM
81
The key structural difference that distinguishes immunoglobulin subclasses is the:
the sequence of the constant regions
82
The IgM molecule is a:
pentamer
83
Which of the following immunoglobuHns is present in the highest concentration in normal human serum?
IgG
84
Which of the following statements about immunoglobuHns is true?
IgA class exists as serum and secretory molecules
85
Antibody idiotype is dictated by the:
variable regions of heavy and Hght chains
86
Antibody allotype is determined by the:
constant regions of heavy and light chains
87
Which IgG subclass is most efficient at crossing the placenta?
IgGl
88
The J-chain is associated with which of the following immunoglobulins?
IgA
89
Macrophage phagocytosis of bacteria is enhanced by which of the following:
opsonin
90
Which of the following is most likely to activate the alternative pathway of complement activation?
haptens
91
Which of the following is the larger residual split portion of C3?
C3b
92
Which of the following activities is associated with C3b?
opsonization
93
After a penicillin injection, a patient rapidly develops respiratory distress, vomiting and hives. This reaction is primarily mediated by:
IgE
94
Which of the following is the "recognition unit" in the classical complement pathway?
Clq
95
In immunofixation electrophoresis:
the antigen is electrophoresed and then monospecific antisera is reacted with it
96
Which of the following is the "membrane attack complex" of complement activation?
C5b, C6, C7, C8, C9
97
Which of the following releases histamine and other mediators from basophils?
C3a
98
A single, reliable screening test for detecting neonatal infection in the absence of clinical signs is:
quantitative serum IgM determination
99
Bence Jones proteins are:
Fab fragments of a monoclonal protein
100
Humoral antibodies are produced by which cells?
Blymphocytes
101
Initiation of the activation mechanism of the alternative complement pathway differs from that of the classical pathway in that:
antigen-antibody complexes containing IgA or IgE may initiate activation
102
Which of the foEowing is cleaved as a result of activation of the classical complement pathway?
C4
103
The component associated only with the alternative pathway of complement activation is:
properdin factor B
104
Potent chemotactic activity is associated with which of the following components of the complement system:
C5a
105
Hereditary angioedema is characterized by:
decreased activity of Cl esterase inhibitor
106
Which of the following has been associated with patients who have homozygous C3 deficiency?
a lifelong history of life-threatening infections
107
Hereditary deficiency of early complement components (Cl, C4 and C2) is associated with:
lupus erythematosus like syndrome
108
Hereditary deficiency of late complement components (C5, C6, C7 or C8) can be associated with which of the following conditions?
a systemic gonococcal infection if exposed
109
Which immunologic mechanism is usually involved in bronchial asthma?
immune complex
110
Antihistamines like Benadryl®:
block HI histamine receptors
111
A child has severe hay fever. A total IgE measurement was performed by the Ouchterlony immunodiffusion method. No lines of precipitation appeared on the immunodiffusion plate. The most likely explanation is:
IgEis in too low a concentration to be detected by this method
112
Which test is used to evaluate the cellular immune system in a patient?
skin test for commonly encountered antigens
113
T cells are incapable of:
secretion of immunoglobulins
114
Tlymphocytes are incapable of functioning as:
phagocyti cells
115
Nonspecific killing of tumor cells is carried out by:
natural killer cells
116
Tumor markers found in the circulation are most frequently measured by:
immunoassays
117
A patient with a B-cell deficiency will most likely exhibit:
increased bacterial infections
118
A patient with a T-cell deficiency will most likely exhibit:
increased parasitic infections
119
Which of the following is an important cellular mediator of immune complex tissue injury?
neutrophil
120
Which of the following mediators is released during T-cell activation?
cytokines
121
Which of the following terms describes a graft between genetically unidentical individuals belonging to the same species?
allograft
122
Tlymphocytes that possess the CDS surface marker mediate which of the following T-cell functions?
cytotoxic
123
Delayed hypersensitivity may be induced by:
contact sensitivity to inorganic chemicals
124
The most rapid immediate hypersensitivity reaction is associated with:
anaphylaxis
125
An immunofluorescence test using reagent antibody directed against the CDS surface marker would identify which of the following cell types in a sample of human peripheral blood?
all mature T lymphocytes
126
In flow cytometry, labeled cells:
scatter the light and emitfluorescence
127
A marked decrease in the CD4 lymphocytes and decrease in the CD4/CD8 ratio:
is associated with a viral induced immunodeficiency
128
What is the immunologic method utilized in the flow cytometer?
immunofluorescence
129
```
Given the following data:
WBC: 5.0x103/L
lymphs: 15%
CD4: 8%
Calculate the absolute CD4:
```
60
130
```
Given this hematologic data:
WBC: 5.0x103/L!L
lymphs: 15%
CD4: 8%
Which of the following is the correct interpretation?
```
consistent with a viral infection such as HIV
131
A patient's abnormal lymphocytes are positive for CD2antigen, lack C3receptors, and are negative for surface immunoglobulin. This can be classified as a disorder of:
T cells
