IMMUNOLOGY & SEROLOGY REVIEW QUESTIONS
Reference: Turgeon’s
d. All of the above
BASIC IMMUNOLOGY/IMMUNE SYSTEM
1.
The first line of defense in protecting the body from
infection includes all the following components
except:
a. Unbroken skin
b. Normal microbial flora
c. Phagocytic leukocytes
d. Secretions such as mucus
2.
Natural immunity is characterized as being:
a. Innate or inborn
b. Able to recognize exogenous or endogenous
agents specifically
c. Able to eliminate exogenous or endogenous
agents selectively
d. Part of the first line of body defenses against
microbial organisms
3. Another term for adaptive immunity is:
a. Antigenic immunity
b. Acquired immunity
c. Lymphocyte reactive immunity
d. Phagocytosis
4. Humoral components of the adaptive immune
system include:
a. T lymphocytes
b. B lymphocytes
c. Antibodies
d. Saliva
5. A synonym for an antigenic determinant is:
a. Immunogen
b. Epitope
c. Binding site
d. Polysaccharide
6. Genetically different individuals of the same
species are referred to as:
a. Allogenic
b. Heterogenic
c. Autogenic
d. Isogenic
7. Antigenic substances can be composed of:
a. Large polysaccharides
b. Proteins
c. Glycoproteins
8. Which of the following characteristics of an
antigen is the least important?
a. Foreignness
b. Degradability
c. Molecular weight
d. Presence of large repeating polymers
9. The chemical composition of an antibody is:
a. Protein
b. Lipid
c. Carbohydrate
d. Any of the above
10. Which of the following statements is false about
an anamnestic response versus a primary
response?
a. Has a shorter lag phase
b. Has a longer plateau
c. Antibodies decline more gradually.
d. IgM antibodies predominate.
11. Which type of antibody is capable of placental
transfer?
a. IgM
b. IgG
c. IgA
d. IgD
12. Which of the following type(s) of bonding is (are)
involved in antigen-antibody reactions?
a. Hydrophobic
b. Hydrogen
c. Van der Waals
d. All of the above
13. Monovalent antibodies have also been referred to
as:
a. Complete antibodies
b. Incomplete antibodies
14. Which of the following is an accurate statement
about monoclonal antibodies (MAbs)?
a. MAbs are antibodies engineered to bind to a
single epitope.
b. MAbs are purified antibodies cloned from a
single cell.
c. MAbs are used to classify and identify specific
cellular membrane characteristics.
d. All of the above are correct.
[Type here]
15. Antigens are characterized by all the following
except that they:
a. Are usually large organic molecules
b. Are usually lipids
c. Can be glycolipids or glycoproteins
d. Are also called immunogens
16. The immunogenicity of an antigen depends
greatly on:
a. Its biochemical composition
b. Being structurally unstable
c. Its degree of foreignness
d. Having a low molecular weight
17. Antibodies are also referred to as:
a. Immunoglobulins
b. Haptens
c. Epitopes
d. Gamma globulins
a. IgG is the predominant antibody type
b. It has a shorter lag phase
c. The antibody titer is lower
d. It has a more gradual decline in antibody
response
21. Bonding of antigen to antibody exists exclusively
as:
a. Hydrogen bonding
b. Van der Waals forces
c. Electrostatic forces
d. Noncovalent bonding
22. The strongest bond of antigen and antibody
chiefly results from the:
a. Type of bonding
b. Goodness of fit
c. Antibody type
d. Quantity of antibody
23. Monoclonal antibodies have all the following
characteristics except:
a. Purified antibodies
b. Cloned from a single cell
c. Engineered to bind to a single specific antigen
d. Frequent occurrence in nature
18.
Possible answers for question 40:
a. Fc segment
b. Fab segment
c. Hinge region
d. Disulfide bond
Possible answers for question 41:
a. Fc segment
b. Fab segment
c. Hinge region
d. Disulfide bond
19. Which of the following statements about IgM is
false?
a. Composed of five basic subunits
b. More efficient in the activation of the
complement cascade and agglutination than IgG
c. Predominant in an initial antibody response
d. Predominant in a secondary (anamnestic)
response
20. In a secondary (anamnestic) response, all the
following characteristics are correct except:
24. The site of hematopoiesis in the first month of
gestation is the:
a. Yolk sac
b. Spleen
c. Liver
d. Bone marrow
25. The principal type of leukocyte in the process of
phagocytosis is the:
a. Eosinophil
b. Basophil
c. Monocyte
d. Neutrophil
26. Chronic granulomatous disease represents a
defect of:
a. Oxidative metabolism
b. Abnormal granulation of neutrophils
c. Diapedesis
d. Chemotaxis
27. A primary function of the eosinophil is:
a. Phagocytosis
b. Suppression of the inflammatory response
[Type here]
c. Reacting in acute, systemic hypersensitivity
reactions
d. Antigen recognition
28. The cells of the mononuclear phagocyte system
include:
a. Monocytes and promonocytes
b. Monocytes and macrophages
c. Lymphocytes and monocytes
d. Both a and b
29. The host defense function(s) of monocytesmacrophages include(s):
a. Antigen presentation
b. Phagocytosis
c. Secretion of biologically active molecules
d. All of the above
30. The surface MHC class II gene product is
important in:
a. Antigen recognition by T lymphocytes
b. Antigen recognition by B lymphocytes
c. Synthesis of antibody by plasma cells
d. Phagocytosis
31. Patients with a marked decrease in neutrophils or
severe defects in neutrophil function have:
a. A high rate of infection
b. Recurrent systemic bacterial infections
c. Recurrent life-threatening fungal infections
d. All of the above
32. Which statement about eosinophils is false?
a. They are homeostatic regulators of
inflammation.
b. They attempt to suppress an inflammatory
reaction.
c. They participate in hypersensitivity reactions.
d. They interact with the larval stages of some
helminth parasites.
33. Which statement about basophils is false?
a. They have a high concentration of heparin in
the granules.
b. They have a high concentration of histamine in
the granules.
c. They react with two adjacent IgA molecules on
mast cells.
d. They are associated with anaphylactic shock.
34. The cells that constitute the physiologic,
mononuclear phagocyte system do not include:
a. Promonocytes and their precursors
b. Monocytes in circulating blood
c. Macrophages in tissues
d. Polymorphonuclear neutrophils
35. A function of the cell-mediated immune response
not associated with humoral immunity is:
a. Defense against viral and bacterial infection
b. Initiation of rejection of foreign tissues and
tumors
c. Defense against fungal and bacterial infection
d. Antibody production
36. The primary or central lymphoid organs in
humans are the:
a. Bursa of Fabricius and thymus
b. Lymph nodes and thymus
c. Bone marrow and/or fetal liver and thymus
d. Lymph nodes and spleen
37. All the following are a function of T cells except:
a. Mediation of delayed-hypersensitivity reactions
b. Mediation of cytolytic reactions
c. Regulation of the immune response
d. Synthesis of antibody
38. All the following are B cell surface membrane
markers except:
a. sIg
b. Fc receptor
c. C3 receptor
d. CD4
39. Most diseases associated with a primary defect
are _______________ disorders.
a. T cell
b. B cell
c. Complement
d. Phagocytic
40. Severe combined immunodeficiency is caused by:
a. T cell depletion
b. B cell depletion
c. Inappropriate development of stem cells
d. Phagocytic dysfunction
41. DiGeorge’s syndrome is caused by:
a. Faulty embryogenesis
b. Deficiency of calcium in utero
[Type here]
c. Inappropriate stem cell development
d. Autosomal recessive disorder
42. The major clinical manifestation of a B cell
deficiency is:
a. Impaired phagocytosis
b. Diminished complement levels
c. Increased susceptibility to bacterial infections
d. Increased susceptibility to parasitic infections
43. Bruton’s agammaglobulinemia is a(n):
a. Acquired disorder
b. Autosomal genetic disorder
c. Sex-linked genetic disorder
d. Disorder occurring primarily in girls
b. Memory cells
c. Phagocytic cells
d. Short-lived cells
50. Which of the following characteristics of T
lymphocytes is false?
a. Can form a suppressor-cytotoxic subset
b. Can be helpers-inducers
c. Can be CD4+ or CD8+
d. Can synthesize and secrete immunoglobulin
51. Natural killer cells:
a. Produce interferon
b. Produce IL-2
c. Were previously called null cells
d. All of the above
44. Which of the following disorders does not result
in a secondary immunodeficiency?
a. Sickle cell disease
b. Uremia
c. AIDS
d. Poison ivy hypersensitivity
52. K-type cells:
a. Synthesize antibody
b. Secrete antibody
c. Destroy by cytotoxic reaction
d. Phagocytize target cells
45. The secondary lymphoid tissues in mammals are:
a. Thymus and bursa of Fabricius
b. Lymph nodes
c. Spleen
d. Both b and
53. The complement system is:
a. A heat-labile series of plasma proteins
b. Composed of many proteinases
c. Composed of three interrelated pathways
d. All of the above
46. In mammalian immunologic development, the
precursors of lymphocytes arise from progenitor
cells of the:
a. Yolk sac
b. Lymph nodes
c. Spleen
d. Both b and c
54. All the following are complement-controlling
proteins except:
a. C1 (INH)
b. Factor I
c. Factor H
d. C3
47. The thymus is embryologically derived from the:
a. Yolk sac
b. Pharyngeal pouches
c. Lymphoblasts
d. Bone marrow
48. The process of aging causes the thymus to:
a. Decrease in size
b. Not change over time
c. Lose cellularity
d. Both a and c
49. T lymphocytes can also be referred to as:
a. Mast cells
55. The three complement activation pathways
converge at the point of cleavage of complement
component _____.
a. C3
b. C5
c. C7
d. C8
56. All the following result from complement
activation except:
a. Decreased cell susceptibility to phagocytosis
b. Blood vessel dilation and increased vascular
permeability
c. Production of inflammatory mediators
d. Cytolysis or hemolysis
[Type here]
57. Fixation of the C1 complement component is
related to each of the following factors except:
a. Molecular weight of the antibody
b. The presence of IgM antibody
c. The presence of most IgG subclasses
d. Spatial constraints
58. At which stage does the complement system
reach its full amplitude?
a. C1q, C1r, C1s complex
b. C2
c. C3
d. C4
59. Which of the following is not a component of the
membrane attack complex?
a. C3b
b. C6
c. C7
d. C8
60. The final steps (C8 and C9) in complement
activation lead to:
a. Cell lysis
b. Phagocytosis
c. Immune opsonin adherence
d. Virus neutralization
61. The alternate complement pathway is(can be):
a. Initiated by the formation of antigen-antibody
reactions
b. Predominantly a non–antibody-initiated
pathway
c. Activated by factors such as endotoxins
d. Both b and c
62. Which of the following conditions can be
associated with hypercomplementemia?
a. Myocardial infarction
b. Systemic lupus erythematosus
c. Glomerulonephritis
d. Subacute bacterial endocarditis
63. A (the) nonspecific component(s) of the immune
system is (are):
a. Complement
b. T cells
c. B cells
d. Both a and b
64. Transforming growth factors:
a. Are products of virally transformed cells
b. Can be a potent inhibitor of IL-1–induced T cell
proliferation in their beta form
c. Are important in inflammation, tumor defense,
and cell growth
d. All of the above
65. Which activity is associated with interferon?
a. Enhances phagocytosis
b. Retards expression of specific genes
c. Promotes complement-mediated cytolysis
d. Interferes with viral replication
66. Tumor necrosis factor (TNF) differs from IL-1 in
that TNF is not able to:
a. Mediate an acute inflammatory reaction
b. Increase the expression of IL-2 receptors
c. Enhance the proliferation and differentiation of
B lymphocytes
d. Stimulate T cell proliferation
IMMUNOLOGIC & SEROLOGIC PROCESS
1. Which of the following is the government agency
primarily responsible for safeguards and
regulations to ensure a safe and healthful
workplace throughout the United States?
a. Occupational Safety and Health Administration
(OSHA)
b. Clinical Laboratory Improvement Amendments
of 1988 (CLIA ’88)
c. Centers for Disease Control and Prevention
(CDC)
d. City ordinances
2. The term Standard Precautions refers to:
a. Treating all specimens as if they are infectious
b. Assuming that every direct contact with a body
fluid is infectious
c. Treating only blood or blood-tinged specimens
as infectious
d. Both a and b
3. The CDC Bloodborne Pathogen Standard and the
OSHA Occupational Exposure Standard mandate:
a. Education and training of all health care
workers in standard precautions
b. Proper handling of chemicals
c. Calibration of equipment
d. Fire extinguisher maintenance
[Type here]
4. The single most common source of human
immunodeficiency virus in the occupational
setting is:
a. Saliva
b. Urine
c. Blood
d. Cerebrospinal fluid
5. Gloves for medical use may be:
a. Sterile or nonsterile
b. Latex or vinyl
c. Used only once
d. All of the above
6. Infectious waste must be discarded into
containers with all the following features except:
a. Marked “Biohazard”
b. Has standard biohazard symbol
c. Orange, orange and black, or red
d. Made of sturdy cardboard for landfill disposal
7. Clinical laboratory personnel need to have
demonstrable immunity to:
a. Rubella
b. Polio
c. Hepatitis B
d. Both a and c
8. 1. A written procedural protocol should contain
the following information, in the correct order:
____, ____, ____, ____. Choose from (A) to (D).
A. Specimen collection and storage
B. Reference values
C. Reagents, supplies, and equipment
D. Procedural method
a. A, B, C, D
b. B, C, A, D
c. A, C, D, B
d. D, C, B, A
9. Factors that can denature, coagulate, or alter
protein molecules include:
a. Heat
b. Strong acid solution
c. Strong alkali solution
d. All of the above
10. 3. If testing cannot be done within _____ hours of
collection, a serum specimen should be frozen at
−20° C.
a. 24
b. 48
c. 72
d. 96
11. Complement can be inactivated in human serum
by heating to _____° C.
a. 25
b. 37
c. 45
d. 56
12. A specimen should be reinactivated when more
than ______ hour(s) has (have) elapsed since
inactivation.
a. 1
b. 2
c. 4
d. 8
13. A graduated pipette can be used when:
a. Extreme accuracy is not needed.
b. Very precise accuracy is needed.
c. Precision is more important than speed.
d. Precision and speed are important.
14. A meniscus is the:
a. Curvature in the top surface of a liquid
b. Zero mark on a pipette
c. Last marking on a serologic pipette
d. Flat line of liquid in a pipette
15. Automatic pipettes have the advantage of:
a. Being fast
b. Allowing repetitive measurement of solutions
c. Delivering equal volumes of solutions
d. All the above
16. A dilution is a(n):
a. Ratio of volume or number of parts of the
substance to be diluted in the total volume, or
parts, of the final solution
b. Indication of relative concentration
c. Frequently used measure in serologic testing
d. All the above
17. If a serial dilution is prepared in 1:2 dilutions, the
final dilution in tube 6 is:
a. 1:25
b. 1:32
c. 1:64
d. 1:256
[Type here]
18. To prepare 10 mL of a diluted serum specimen
1:10, ____ part of serum is needed.
a. 1.0
b. 0.75
c. 0.50
d. 0.20
19. ____ parts of distilled water is (are) needed to
reach the total volume.
a. 10
b. 9
c. 4.5
d. 0.1
20. Serum for detection of antibodies should be
drawn during the:
a. Acute phase of illness only
b. Acute and convalescent phases of illness
c. Convalescent phase of illness only
d. Acute and convalescent phases, as well as 6
months after an illness
21. A central concept of serologic testing is:
a. Antigen-antibody interaction
b. Determination of antibody composition
c. Quantitation of antigen titer
d. Manifestation of a rise in antibody titer
a. False-positive reaction
b. False-negative reaction
c. Enhanced agglutination
d. Diminished antigen response
26. The effect of competing antibodies seeking to
attach to antigen sites is called:
a. Prozone phenomenon
b. Ionic strength
c. Steric hindrance
d. Sensitization
27. All the following are methods that can be used to
enhance the agglutination of IgG antibodies
except:
a. Centrifugation
b. Treatment with proteolytic enzymes
c. Acidifying the mixture
d. Using colloids
28. A classic technique for the detection of viral
antibodies is:
a. Passive hemagglutination
b. Indirect hemagglutination
c. Hemagglutination inhibition
d. Latex particle agglutination
22. The quality of test results in an agglutination
reaction depends on all the following except:
a. Duration of incubation
b. Amount of antigen conjugated to the carrier
c. Avidity of antigen conjugated to the carrier
d. Whether the carrier is artificial or biological
29. Artificial or biological carriers that can be used in
an agglutination reaction include:
a. Latex particles
b. Colloidal charcoal
c. Erythrocytes coated with antigen in a constant
amount
d. All of the above
23. Flocculation procedures differ from latex
agglutination procedures because:
a. Antigen is bound to a carrier.
b. Antibody is bound to a carrier.
c. Soluble antigen reacts with antibody.
d. Flocculation procedures are only qualitative.
30. Sensitization:
a. Is the first phase of agglutination
b. Represents the physical attachment of antibody
molecules to antigens on the RBC membrane
c. Is an irreversible reaction
d. Both a and b
24. In the hemagglutination technique, antihuman
globulin is used as an enhancement medium to
detect _______ antibodies.
a. IgM
b. IgG
c. IgD
d. IgE
31. Agglutination can be used to enhance reactions by
all the following means except:
a. Decreasing ionic strength of the reaction
b. Centrifugation
c. Increasing pH of the reaction
d. Using colloids and antihuman globulin
25. The prozone phenomenon can result in a (an):
32. All the following statements are correct regarding
human pregnancy testing except:
[Type here]
a. Tests detect human chorionic gonadotropin
(hCG).
b. The hCG is secreted by the trophoblast of the
developing embryo.
c. The presence of hCG rapidly increases in urine
or serum.
d. The presence of hCG in maternal urine or
serum persists throughout pregnancy.
33. All the following statements are correct regarding
hCG except:
a. It helps maintain the corpus luteum.
b. It stimulates production of progesterone.
c. It is detectable within 102 hours after the last
expected menstrual period.
d. It reaches peak levels at 2 to 3 months after the
last menstrual period.
34. The most common laboratory method for
detecting hCG is:
a. Latex agglutination
b. Enzyme-linked immunosorbent assay
c. Immunofluorescence
d. Antibody titration
35. In the latex agglutination method for the
detection of hCG, no agglutination indicates the:
a. Absence of hCG
b. Presence of hCG
c. Absence of hCG, a positive test
d. Presence of hCG, a negative test
36. A false-positive reaction in a latex agglutination
test for hCG can be caused by all the following
except:
a. Chorioepithelioma
b. Hydatidiform mole
c. Taking oral contraceptives
d. Excessive ingestion of aspirin
37. Protein can be separated into ___________
fractions by use of serum electrophoresis.
a. Three
b. Four
c. Five
d. Six
38. Which of the following is the most common
application of immunoelectrophoresis (IEP)?
a. Identification of the absence of a normal serum
protein
b. Structural abnormalities of proteins
c. Screening for circulating immune complexes
d. Diagnosis of monoclonal gammopathies
39. Abnormalities of precipitin bands in an IEP assay
can be evaluated by all the following features
except:
a. Position of the band between antigen well and
antibody trough
b. Position of the band in relationship to
electrophoretically identified protein fractions
c. General location of the band
d. Distortion of the arc formation
40. Immunofixation electrophoresis (IFE) is best used
in the:
a. Workup of a polyclonal gammopathy
b. Workup of a monoclonal gammopathy
c. Screening for circulating immune complexes
d. Identification of hypercomplementemia
41. Immunoelectrophoresis (IEP) involves:
a. Separation of proteins based on the rate of
migration of individual components in an
electrical field
b. Electrophoresis of serum or urine
c. Double immunodiffusion following
electrophoresis
d. All of the above
42. In IEP, proteins are differentiated by:
a. Electrophoresis
b. Diffusion coefficient
c. Antibody specificity
d. All of the above
43. IEP can divide the proteins of normal serum into
___________ distinct precipitation bands.
a. 5 to 10
b. 15 to 20
c. 25 to 40
d. 45 to 100
44. IEP is useful for clinically detecting:
a. Structural abnormalities
b. Concentration changes in proteins
c. Congenital deficiency of some complement
components
d. All of the above
[Type here]
45. The most common application of IEP of serum is
for the:
a. Diagnosis of monoclonal gammopathy
b. Diagnosis of polyclonal gammopathy
c. Diagnosis of autoimmune hemolysis
d. Demonstration of Bence Jones (BJ) protein
46. Immunofixation electrophoresis (IFE) can test:
a. Serum and urine
b. Cerebrospinal fluid
c. Whole blood
d. Both a and b
47. The primary use of IFE is:
a. Characterization of monoclonal
immunoglobulins
b. Characterization of polyclonal immunoglobulins
c. Identification of monoclonal immunoglobulins
d. Identification of polyclonal immunoglobulins
48. Chemiluminescence:
a. Has excellent sensitivity and dynamic range
b. Does not require sample radiation
c. Uses unstable chemiluminescent reagents and
conjugates
d. Both a and b
49. Enzyme labels often used in indirect procedures
are:
a. Alkaline phosphatase
b. Horseradish peroxidase
c. Beta-galactosidase
d. All of the above
50. For an enzyme to be used in an EIA, it must meet
all the following criteria except:
a. High amount of stability
b. Extreme specificity
c. Presence in antigen or antibody
d. No alteration by inhibitor with the system
51. Nephelometry measures the light scatter of:
a. Ions
b. Macromolecules c
. Antibodies
d. Soluble antigens
52. Nephelometry can be used to assay all the
following except:
a. IgM
b. IgG
c. IgD
d. IgA
53. Cryoglobulins are proteins that precipitate or gel
when cooled to:
a. −18° C (−0.4° F)
b. 0° C (32° F)
c. 4° C (39° F)
d. 18° C (64° F)
54. Cryoglobulin analysis can be useful in the
diagnosis of:
a. Hypothermia
b. Raynaud’s phenomenon
c. Hepatitis C
d. Rheumatoid arthritis
55. Laser is an acronym for:
a. Light amplification by stimulated emission of
radiation
b. Light augmentation by stimulated emitted
radiation
c. Light amplified by stimulated energy radiation
d. Large angle stimulation by emitted radiation
56. All the following are descriptive characteristics of
laser light except:
a. Intensity
b. Stability
c. Polychromaticity
d. Monochromaticity
57. A photon is a:
a. Basic unit of light
b. Basic unit of all radiation
c. Component of an atom
d. Component of laser light
58. The major application of flow cell technology is:
a. Identification of cells
b. Cell sorting before further analysis
c. Diagnosis of autoimmune disease
d. Both a and b
59. Four-color immunofluorescence typically uses:
a. Fluorescein isothiocyanate (FITC)
b. Phycoerythrin (PE)
c. Peridinin chlorophyll protein (PerCP)
d. All of the above
[Type here]
INFECTIOUS DISEASES
1. Factors that influence the development of an
infectious disease include all the following except
the:
a. Immune status of the individual
b. Incidence of an organism in the population
c. Pathogenicity of the agent
d. Sole presence of the agent or microorganism
2. The detection of _________ can be of diagnostic
significance during the first exposure of a patient
to an infectious agent.
a. IgM
b. IgG
c. IgA
d. IgD
3. Serologic procedures for the diagnosis of recent
infection should include:
a. Only an acute specimen
b. Only a convalescent specimen
c. Acute and convalescent specimens
d. Acute, convalescent, and 6-month postinfection
specimens
4. An important factor affecting microbial disease
development is the:
a. Ability of some microorganisms to multiply in
an intracellular habitat
b. Display of antigen variation
c. Presence of a related microorganism
d. Both a and b
5. For an infectious disease to develop in a host, the
organism must initially:
a. Survive phagocytosis
b. Be in the log phase of multiplication
c. Penetrate the skin or mucous membrane
barrier
d. Be present in the host for 7 to 10 days
6. The first type of antibody that may be apparent in
the immune response to an infectious disease is:
a. IgM
b. IgG
c. IgD
d. IgA
7. A distinguishing characteristic of the
herpesviruses is that:
a. They are cell-associated viruses.
b. They are enveloped RNA.
c. Human beings are the only known reservoir of
infection.
d. Both a and c
8. Up to _________ of infants develop antibody to
HHV-6 by 10 to 11 months of age.
a. 25%
b. 50%
c. 75%
d. 95%
9. Varicella-zoster virus causes:
a. Chickenpox
b. Shingles
c. Measles
d. Both a and b
10. Varicella-zoster virus can be reactivated in:
a. AIDS patients
b. Older adults
c. Immunocompromised persons
d. All of the above
11. Rapid preliminary diagnosis of varicella-zoster
virus can be done in the laboratory by:
a. Direct immunofluorescence
b. Viral isolation
c. ELISA method
d. Complement fixation
12. Histoplasmosis is caused by a:
a. Bacterium
b. Parasite
c. Fungus
d. Virus
13. Aspergillosis is:
a. An opportunistic organism
b. Caused by a parasite
c. A cause of skin infections
d. A relatively mild disease
14. The first test to be positive in coccidioidomycosis
is:
a. Fluorescent antibody
b. Hypersensitivity testing
c. Complement fixation
d. Culture of the organism
[Type here]
15. The Center for Biologics Evaluation and Research
CBER regulates:
a. Laboratory safety
b. Vaccine products
c. Personnel qualifications
d. Research grants
22. Substances produced by S. pyogenes include all
the following except:
a. Hyaluronidase
b. DNAses (A, B, C, D)
c. Erythrogenic toxin
d. Interferon
16. Pathogens adapted for biological warfare include:
(1) Smallpox (2) Bacillus anthracis (3) Chickenpox
(4) Q fever
a. 1, 2, 3
b. 1, 2, 4
c. 2, 3, 4
d. 1, 3, 4
23. Laboratory diagnosis of S. pyogenes can be made
by all the following except:
a. Culturing of throat or nasal specimens
b. Febrile agglutinins
c. ASO procedure
d. Anti–DNase B
17. Vaccines can be divided into _________ vaccines.
a. Live, attenuated
b. Nonreplicating
c. Naked DNA
d. Both a and b
18. To meet FDA requirements, a vaccine must:
a. Produce protective immunity with only minimal
side effects.
b. Be immunogenic enough to produce a strong
and measurable immune response.
c. Be stable during its shelf life.
d. All of the above.
19. The earliest host response to vaccination is a(n):
a. Innate immune response
b. Memory response
c. Anamnestic response
d. Both a and b
20. S. pyogenes is the most common causative agent
of all the following disorders and complications
except:
a. Pharyngitis
b. Gastroenteritis
c. Scarlet fever
d. Impetigo
21. All the following characteristics are descriptive of
M protein except:
a. No known biological role
b. Found in association with the hyaluronic
capsule
c. Inhibits phagocytosis
d. Antibody against M protein provides typespecific immunity
24. False ASO results may be caused by all the
following except:
a. Room temperature reagents and specimens at
the time of testing
b. The presence of beta-lipoprotein
c. Bacterial contamination of the serum specimen
d. Oxidation of ASO reagent caused by shaking or
aeration of the reagent vial
25. Members of the S. pyogenes species are almost
always _____ hemolytic.
a. Alphab. Betac. gammad. Alpha- or beta26. Long-term complications of S. pyogenes infection
can include:
a. Acute rheumatic fever
b. Poststreptococcal glomerulonephritis
c. Rheumatoid arthritis
d. Both a and b
27. Particularly virulent serotypes of S. pyogenes
produce proteolytic enzymes that cause
__________________ in a wound or lesion on an
extremity.
a. Necrotizing fasciitis
b. Bone degeneration
c. Burning and itching
d. Severe inflammation
28. All the following characteristics of S. pyogenes are
correct except:
a. It is an uncommon pathogen.
b. It occurs most frequently in school-age
children.
[Type here]
c. It is spread by contact with large droplets
produced in the upper respiratory tract.
d. It has been known to cause foodborne and
milkborne epidemics.
29. The clinical manifestations of S. pyogenes–
associated upper respiratory infection are:
a. Mild and usually unnoticeable
b. Age dependent
c. Associated with cold sores
d. Difficult to detect
30. The most reliable immunologic test for recent S.
pyogenes skin infection is:
a. ASO
b. Anti–DNAse B
c. Anti-NADase
d. Antibody to erythrogenic toxin
31. If a streptococcal infection is suspected, but the
ASO titer does not exceed the reference range,
a(n) _________________ should be performed.
a. Repeat titer
b. Anti–DNAse B test c. Anti-NADase test
d. Throat culture
32. The classic tests to demonstrate the presence of
streptococcal infection are:
a. ASO and anti-NADase
b. ASO and anti–DNAse B
c. Anti-NADase and anti-DNAse
d. Both a and b
33. The highest reported levels of sensitivity testing
for group A streptococci are in:
a. ASO titers
b. Direct latex agglutination tests
c. Surface (optical) immunoassay
d. Both a and b, which are equivalent
34. Which of the following is a term for
nontreponemal antibodies produced by an
infected patient against components of their own
or other mammalian cells?
a. Autoagglutinins
b. Reagin antibodies
c. Alloantibodies
d. Nonsyphilis antibodies
35. In the RPR procedure, a false-positive reaction can
result from all the following except:
a. Infectious mononucleosis
b. Leprosy
c. Rheumatoid arthritis
d. Streptococcal pharyngitis
36. The first diagnostic blood test for syphilis was the:
a. VDRL
b. Wassermann
c. RPR
d. Colloidal gold
37. Syphilis was initially treated with:
a. Fuller’s earth
b. Heavy metals (e.g., arsenic)
c. Sulfonamides (e.g., triple sulfa)
d. Antibiotics (e.g., penicillin)
38. Direct examination of the treponemes is most
often performed by:
a. Light microscopy
b. Darkfield microscopy
c. VDRL testing
d. RPR testing
39. Pathogenic treponemes _______________
cultivatable with consistency in artificial
laboratory media.
a. Are
b. Are not
40. In infected blood, T. pallidum does not appear to
survive at 4° C (39 ° F) for longer than:
a. 1 day
b. 2 days
c. 3 days
d. 5 days
41. The primary incubation period for syphilis (T.
pallidum) is usually about:
a. 1 week
b. 2 weeks
c. 3 weeks
d. 4 weeks
42. The stage of syphilis that can be diagnosed only by
serologic (laboratory) methods is the:
a. Incubation phase
b. Primary phase
c. Secondary phase
d. Latent phase
[Type here]
43. Immunocompetent patients infected with T.
pallidum produce:
a. Specific antibodies against T. pallidum
b. Nonspecific antibodies against the protein
antigen group common to pathogenic spirochetes
c. Reagin antibodies
d. All of the above
44. Toxoplasmosis is a ________ infection.
a. Bacterial
b. Mycotic
c. Parasitic
d. Viral
45. The definitive host of T. gondii is the:
a. Horse
b. Pig
c. Dog
d. Domestic cat
46. All the following are specific methods for
preventing congenital toxoplasmosis except:
a. Avoid touching mucous membranes while
handling raw meat.
b. Wash hands thoroughly after handling raw
meat.
c. Eliminate food contamination by flies,
cockroaches, and other insects.
d. Dispose of fecally contaminated cat litter into
plastic garbage bags.
47. The presence of IgM antibodies to T. gondii in an
adult is indicative of a(an):
a. Carrier state
b. Active infection
c. Chronic infection
d. Latent disease
48. All the following characteristics are correct
regarding toxoplasmosis except:
a. It is recognized as a tissue coccidian.
b. Domestic dogs are a source of the disease.
c. It can be transmitted by infected blood.
d. It can be transmitted transplacentally.
49. Toxoplasmosis is a serious health threat to:
a. AIDS patients
b. Adults
c. Children older than 2 years
d. Older patients
50. Congenital toxoplasmosis can cause:
a. Congenital heart disease
b. Central nervous system malformation
c. Urinary tract infections
d. Muscular disorders
51. Antibodies to T. gondii are demonstrable _______
after infection.
a. 3 to 5 days
b. Within 10 days
c. Within 2 weeks
d. Within 4 weeks
52. The method of choice for detecting IgM
antibodies in toxoplasmosis is:
a. Enzyme-linked immunosorbent assay (ELISA)
b. Indirect fluorescent antibody (IFA)
c. Indirect hemagglutination (IHA)
d. Complement fixation (CF)
53. The Epstein-Barr virus can cause all the following
except:
a. Infectious mononucleosis
b. Burkitt’s lymphoma
c. Nasopharyngeal carcinoma
d. Neoplasms of the bone marrow
54. The primary mode of EBV transmission is:
a. Exposure to blood
b. Exposure to oral-pharyngeal secretions
c. Congenital transmission
d. Fecal contamination of drinking water
55. Infants infected with EBV are more likely to
experience symptomatic infection than EBVinfected adolescents.
a. True
b. False
56. IgM heterophile antibody is characterized by all
the following features except:
a. Reacts with horse, ox, and sheep RBCs
b. Absorbed by beef erythrocytes
c. Absorbed by guinea pig kidney cells
d. Does not react with EBV-specific antigens
57. Characteristics of EBV-infected lymphocytes
include all the following except:
a. B type
b. Expression of viral capsid antigen
c. Expression of early antigen
[Type here]
d. Expression of EBV genome
58. Which of the following stages of infectious
mononucleosis infection is characterized by
antibody to Epstein-Barr nuclear antigen (EBNA)?
a. Recent (acute) infection
b. Past infection (convalescent) period
c. Reactivation of latent infection
d. Both b and c
59. Which of the following stages of infectious
mononucleosis infection is (are) characterized by
heterophile antibody?
a. Recent (acute) infection
b. Past infection (convalescent) period
c. Reactivation of latent infection
d. Both a and c
60. What percentage of the world’s population is
exposed to EBV?
a. 25%
b. 50%
c. 75%
d. 95%
61. Infectious mononucleosis postperfusion syndrome
is a primary infection resulting from a blood
transfusion from a(n) _______ to a(n) _______
recipient.
a. Immune; nonimmune
b. Nonimmune; immune
c. Infected; nonimmune
d. Infected; immune
62. In infectious mononucleosis, there is no:
a. Acute state
b. Latent state
c. Carrier state
d. Reactivation
63. The incubation period of infectious
mononucleosis is:
a. 2 to 4 days
b. 10 to 15 days
c. 10 to 50 days
d. 51 to 90 days
64. The use of horse erythrocytes in rapid slide tests
for infectious mononucleosis increases their:
a. Cost
b. Sensitivity
c. Specificity
d. Both b and c
65. EBV-infected B lymphocytes express all the
following new antigens except:
a. Viral capsid antigen VCA
b. Early antigen EA
c. Cytoplasmic antigen (CA)
d. Nuclear antigen NA
66. Anti-EBNA IgG does not appear until a patient has
entered the:
a. Initial phase of infection
b. Primary infection phase
c. Convalescent period
d. Reactivation of infectious stage
67. Of patients in the United States with chronic
hepatitis B, _______ of them acquired the virus in
childhood.
a. Less than 20%
b. 20% to 30%
c. 30% to 40%
d. More than 40%
68. The rate of posttransfusion hepatitis C decreased
to _______ after the introduction of serologic
testing in the screening of blood donors.
a. Less than 1%
b. 5%
c. 10%
d. 15%
69. Which form of hepatitis does not have a chronic
form of the disease?
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
70. Another name for hepatitis B infection is:
a. Infectious hepatitis
b. Long incubation hepatitis
c. Australia antigen
d. Dane particle
71. The most frequent clinical response to hepatitis B
virus is:
a. Jaundice within 75 days
b. Asymptomatic infection
c. Subclinical infection
d. Both b and c
[Type here]
72. The first laboratory screening test of donor blood
was for the detection of:
a. HBc
b. HBsAg
c. HBe
d. Anti-HBe
79. The earliest detectable serologic marker of acute
hepatitis C is:
a. Anti-HCV
b. Anti-HBc and liver serum enzyme abnormalities
c. HCV-RNA
d. Anti-HBs and anti-HBc
73. Which surface marker is a reliable marker for the
presence of high levels of hepatitis B virus (HBV )
and a high degree of infectivity?
a. HBeAg
b. HBsAg
c. HBcAg
d. Anti-HBsAg
80. Primary hepatitis viruses are given this name
because they primarily attack:
a. A variety of body systems
b. The liver
c. The skin
d. The nervous system
74. The only serologic marker during the anti-core
window period of hepatitis B (the time between
disappearance of detectable HBsAg and
appearance of detectable antiHBs) may be:
a. Anti-HBs
b. Anti-HBc
c. Anti-HBe
d. HBsAg
75. Which of the following is a characteristic of the
delta agent?
a. Is a DNA virus
b. Usually replicates only in HBV-infected hosts
c. Infects patients who are HBcAg positive
d. Is frequently found in the United States
76. Which of the following viruses is rarely implicated
in transfusion-associated hepatitis?
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Cytomegalovirus
77. In health care workers, the risk of contracting
hepatitis C is _______the risk of contracting AIDS.
a. Lower than
b. Higher than
c. The same as
d. Not something to worry about compared to
78. The specific diagnostic test for hepatitis C is:
a. Absence of anti-HAV and anti-HBsAg
b. Increase in liver serum enzyme levels
c. Detection of non-A, non-B antibodies
d. Anti-HCV
81. Hepatitis A has all the following characteristics
except:
a. DNA virus
b. Short-incubation hepatitis
c. Crowded, unsanitary conditions as a risk factor
d. Rare occurrence of transfusion acquisition
82. The Australia antigen is now called:
a. Dane particle
b. Long-incubation hepatitis
c. Hepatitis B surface antigen (HBsAg)
d. Hepatitis B core antigen (HBcAg)
83. In a patient with primary rubella infection, the
appearance of _______ antibodies is associated
with the clinical signs and symptoms, when
present.
a. IgG
b. IgM
c. IgD
d. Both a and b
84. Testing for _______ antibody is invaluable for the
diagnosis of congenital rubella syndrome.
a. IgM
b. IgG
c. IgD
d. IgE
85. Laboratory confirmation of rubeola antibody is
done by:
a. Detection of IgM antibodies in serum
b. Detection of measles virus RNA by nucleic acid
amplification in a clinical specimen
c. Isolation of rubella virus
d. Either a or b
[Type here]
86. The major structural protein (core) of the HIV-1
virus is:
a. gp41
b. p24
c. gp34
d. gp140
87. The infectious process of AIDS begins when the
gp120 protein on the viral envelope bends to the
protein receptor, _______, on the surface of a
target cell.
a. CD8
b. CD4
c. p24
d. p26
88. HIV can infect all of the following cells except:
a. CD4+ subset of lymphocytes
b. Macrophages
c. Monocytes
d. Polymorphonuclear leukocytes
89. The most rapidly growing segment of the HIVinfected population is:
a. Homosexual males
b. Lesbians
c. Health care workers
d. IV drug users and their sexual partners
90. In HIV infections, a window period of
seronegativity extends from the time of initial
infection up to:
a. 2 weeks
b. 2 to 6 weeks or longer
c. 6 to 12 weeks or longer
d. 4 to 8 months or longer
91. The AIDS-causing virus HIV has also been referred
to as:
a. Human T-lymphotropic virus type III
b. HTLV-III
c. Lymphadenopathy-associated virus (LAV )
d. All of the above
92. HTLV-III was unique when it was isolated because
it:
a. Is a bovine infectious retrovirus
b. Is a canine infectious retrovirus
c. Was identified as the cause of AIDS
d. Is a DNA containing virus
93. The criteria for HIV infection for persons 13 years
of age or older include:
a. Repeatedly reactive screening test for HIV
antibody
b. Specific HIV antibody identified by use of
supplemental tests
c. Direct identification of the virus
d. All of the above
94. After the early period of primary HIV infection,
the patient enters a period of clinical latency that
lasts a median of _______ years.
a. 5
b. 10
c. 15
d. 20
95. As AIDS progresses, the quantity of _______
diminishes and the risk of opportunistic infection
increases.
a. HIV antigen
b. HIV antibody
c. CD4+ T lymphocytes
d. CD8+ T lymphocytes
96. The clinical symptoms of the later phase of AIDS
are:
a. Weight loss and decreased polymorphonuclear
leukocyte (PMN) cells
b. Extreme weight loss and fever
c. Multiple secondary (opportunistic) infections
d. Both b and c
97. The most frequent malignancy observed in AIDS
patients is:
a. Pneumocystis jiroveci (P. carinii)
b. Kaposi’s sarcoma
c. Toxoplasmosis
d. Non-Hodgkin’s lymphoma
98. Sources of error in the Western blot test include:
a. Concentration of HIV antigen
b. Presence of other infectious agents
c. Technical skill and experience of the
technologist performing the test
d. Age of the blood specimen
99. All the following methods have been developed to
detect HIV-1 antigen except:
a. Transcriptase method
[Type here]
b. Synthetic peptide approach
c. Immunofluorescence assay
d. Immunohistochemical staining
100. All the following methods have been developed
to detect the presence of HIV-1 viral gene
except:
a. Radioimmunoassay
b. In situ hybridization
c. Southern blot analysis
d. DNA amplification
IMMUNE DISORDERS
1. Match the following types of hypersensitivity with
their respective type of reaction.
1. ______ Type I hypersensitivity
2. ______ Type II hypersensitivity
3. ______ Type III hypersensitivity
4. ______ Type IV hypersensitivity
a. Cytotoxic reaction
b. Cell-mediated reaction
c. Immune complex reaction
d. Anaphylactic reaction
2. With which cell type are anaphylactic reactions
associated?
a. T lymphocyte
b. B lymphocyte
c. Monocyte
d. Mast
3. Type III reactions are exemplified by all the
following except:
a. Arthus reaction
b. Serum sickness
c. Glomerulonephritis
d. Shingles
4. Type IV reactions are responsible for all the
following except:
a. Contact sensitivity
b. Delayed hypersensitivity
c. Elimination of tumor cells bearing neoantigens
d. Hemolysis of red blood cells
5. Type I hypersensitivity reactions can be associated
with:
a. Food allergies
b. Hay fever
c. Asthma
d. All of the above
6. The most common agents that cause anaphylactic
reactions are:
a. Drugs and food
b. Drugs and insect stings
c. Poison ivy and insect stings
d. Food and insect stings
7. In vitro evaluation of type I hypersensitivity
reactions can include:
a. RIST
b. Skin testing
c. Neither a nor b
d. Both a and b
8. Cytotoxic reactions are characterized by the
interaction of:
a. IgG to soluble antigen
b. IgG to cell-bound antigen
c. IgM to soluble antigen
d. IgM or IgG to cell-bound antigen
9. An example of a delayed nonhemolytic (type II
hypersensitivity) reaction is:
a. Febrile reaction
b. Graft-versus-host disease
c. Urticaria
d. Congestive heart failure
10. Under normal conditions, immune complexes
protect the host because they:
a. Facilitate the clearance of various antigens
b. Facilitate the clearance of invading
microorganisms
c. Interact with complement
d. Both a and b
11. Immune complexes can:
a. Suppress or augment the immune response by
interacting with T and B cells
b. Inhibit tumor cell destruction
c. Be deposited in blood vessel walls
d. All of the above
12. The general anatomic sites of antigen-antibody
interaction are:
a. Tissues with a large filtration area
b. Interstitial fluids
[Type here]
c. Cell surface membranes or fixed intercellular
structures
d. All of the above
13. Type IV hypersensitivity reactions are responsible
for all the following except:
a. Contact sensitivity
b. Elimination of tumor cells
c. Rejection of foreign tissue grafts
d. Serum sickness
14. Polyclonal gammopathies can be exhibited as a
secondary manifestation of all the following
except:
a. Chronic infection
b. Chronic liver disease
c. Multiple myeloma
d. Rheumatoid connective disease
c. 0° C
d. 4° C
20. Monoclonal gammopathy involves elevated levels
of a single class and type of immunoglobulin
referred to as:
a. Monoclonal protein
b. M protein
c. Paraprotein
d. All of the above
21. Most patients with multiple myeloma manifest:
a. Bone pain
b. Acute renal failure
c. No symptoms
d. Hepatomegaly and splenomegaly
15. What is the most frequent cause of death in a
patient with multiple myeloma?
a. Skeletal destruction
b. Chronic renal failure
c. Neurologic disorders
d. Infectious disease
16. atients with multiple myeloma have defects in:
a. Cellular immunity
b. Humoral immunity
c. Synthesis of normal immunoglobulins
d. Both b and c
17. What is the most consistent immunologic feature
of multiple myeloma?
a. Synthesis of dysfunctional single monoclonal
proteins
b. Synthesis of Ig chains or fragments
c. Presence of M protein in serum and/or urine
d. All of the above
18. M proteins are associated with all the following
malignant conditions except:
a. Multiple myeloma
b. Plasmacytoma
c. Malignant lymphoproliferative diseases
d. Lymphoma
19. Cryoglobulins are proteins that precipitate or gel
at:
a. −18° C
b. −4° C
22. The figure above represents the serum
electrophoresis of a patient with:
a. Waldenström’s macroglobulinemia
b. Multiple myeloma
c. No protein abnormality
d. Polyclonal gammopathy 1
23. Patients with Waldenström’s macroglobulinemia
exhibit abnormally large amounts of:
a. IgM
b. IgG
c. IgE
d. IgA
24. Monoclonal gammopathy of undetermined
significance (MGUS) represents a:
a. Monoclonal protein in patients with no features
of multiple myeloma or related malignant
disorders
b. Disorder that can evolve into a malignant
monoclonal gammopathy
c. Serum monoclonal protein concentration less
than 3 g/dL
[Type here]
d. All of the above
25. MGUS is characterized by all the following except:
a. Fewer than 10% plasma cells in the bone
marrow
b. Presence of lytic bone lesions
c. Anemia
d. Hypercalcemia
26. Light-chain disease represents about ________ of
monoclonal gammopathies.
a. 5% to 10%
b. 10% to 15%
c. 15% to 25%
d. 25% to 50%
27. All the following characteristics are common to
organspecific and organ-nonspecific disorders
except:
a. Autoantibody tests are of diagnostic value.
b. Antibodies may appear in each of the main
immunoglobulin classes.
c. Antigens are available to lymphoid system in
low concentrations.
d. Circulatory autoantibodies react with normal
body constituents.
28. Antibody expression in the development of
autoimmunity is regulated by all the following
factors except:
a. Genetic predisposition
b. Increasing age
c. Environmental factors (e.g., ultraviolet [UV]
radiation)
d. Active infectious disease
29. The mechanism responsible for autoimmune
disorder is:
a. Circulating immune complexes
b. Antigen excess
c. Antibody excess
d. Antigen deficiency
30. One of the mechanisms believed to induce selftolerance is:
a. Induction of responsiveness in
immunocompetent cells
b. Elimination of clone programmed to react with
antigen
c. Decreased suppressor cell activity
d. Stimulation of clones of immunocompetent
cells
31. The term autoimmune disorder is used when:
a. Demonstrable immunoglobulins display
specificity for self antigens.
b. Cytotoxic T cells display specificity for self
antigens.
c. Cytotoxic T cells contribute to the pathogenesis
of the disease.
d. All of the above
32. Self-recognition (tolerance) is induced by:
a. Burnet’s clonal selection theory
b. Elimination of the small clone of
immunocompetent cells programmed to react
with the antigen
c. Induction of unresponsiveness in the
immunocompetent cells through excessive
antigen binding
d. All of the above
33. The immunologic manifestations of multiple
sclerosis include all the following except:
a. Antimyelin antibodies
b. An oligoclonal increase in CSF immunoglobulin
c. In vitro antibody-mediated immunity
d. An increase in certain HLA and Ia antigens
34. Most immunologically mediated renal diseases fall
into one of the following categories, except for:
a. Association with circulating immune complexes
b. Association with circulating antigen
c. Association with anti–glomerular basement
membrane antibody
d. Membranoproliferative glomerulonephritis
35. Polymyositis and dermatomyositis are the most
common expressions of:
a. Rheumatoid heart disease
b. Skeletal muscle disorders
c. Rheumatoid arthritis
d. Either a or b
36. The immunologic abnormality associated with
autoimmune pancreatitis in the Japanese
population is:
a. Autoantibodies against carbonic anhydrase
b. HLA haplotype
c. Hypogammaglobulinemia
d. Elevated serum IgE levels
[Type here]
37. SLE is more common in:
a. Female infants
b. Male infants
c. Adolescent through middle-aged women
d. Adolescent through middle-aged men
38. One of the most potent inducers of abnormalities
and clinical manifestations of SLE is:
a. Chloramphenicol
b. Procainamide hydrochloride
c. Isoniazid
d. Penicillin
39. The cellular aberrations in SLE include:
a. B cell depletion
b. Deficiency of suppressor T cell function
c. Hyperproduction of helper T cells
d. Both b and c
40. The principal demonstrable antibody in SLE is
antibody to:
a. Nuclear antigen
b. Cell surface antigens of hematopoietic cells
c. Cell surface antigens to neuronal cells
d. Lymphocytic leukocytes
41. The sites of immune complex deposition in SLE
are influenced by all the following factors except:
a. Molecular size
b. Molecular configuration
c. Immune complex specificity
d. Immunoglobulin class
42. Renal disease secondary to SLE can be assessed
by:
a. Antibody to native dsDNA
b. Levels of C3 and C4
c. Levels of ANA
d. All of the above
43. SLE is a classic model of autoimmune disease and
is a(n):
a. Abnormality of the joints
b. Systemic rheumatoid disorder
c. Abnormality of connective tissue
d. All of the above
44. The overall incidence of SLE has an increased
frequency among:
a. Blacks
b. Native Americans
c. Puerto Ricans
d. All of the above
45. Patients with SLE characteristically manifest:
a. Butterfly rash over the bridge of the nose
b. Skin lesions on the arms and legs
c. Ulcerations on the trunk
d. Photophobia
46. Laboratory features of SLE include:
a. The presence of ANAs
b. Circulating anticoagulant and immune
complexes
c. Decreased levels of complement
d. All of the above
47. Laboratory procedures that are helpful in
assessing renal disease include:
a. Antibody to double-stranded DNA
b. Levels of C3 and C4
c. Cryoglobulin assay
d. All of the above
48. Antinuclear antibodies (ANAs) are always
indicative of SLE.
a. True
b. False
49. Rheumatoid arthritis most frequently develops in:
a. Adolescent females
b. Adolescent males
c. Middle-aged women
d. Middle-aged men
50. Worldwide the incidence of rheumatoid arthritis
is:
a. 1% to 2%
b. 2% to 4%
c. 5% to 10%
d. More than 10%
51. Women are _______ likely than men to develop
rheumatoid arthritis.
a. Less
b. Equally
c. Two to three times more
d. 10 to 20 times more
52. Rheumatoid factor is defined as:
[Type here]
a. Antigens with specificity for antibody
determinants on the Fc fragment of human or
certain animal IgG
b. Antibodies with specificity for antigen
determinants on the Fc fragment of human or
certain animal IgG
c. Antigens with specificity for antibody
determinants on the Fc fragment of human or
certain animal IgD
d. Antibodies with specificity for antigen
determinants on the Fc fragment of human or
certain animal IgD
53. All the following are criteria for rheumatoid
arthritis except:
a. Morning stiffness
b. Evening stiffness
c. Rheumatoid nodules
d. Radiographic changes
54. 1RF correlates with all the following except:
a. The severity of the disease in general
b. The presence of nodules
c. Other organ system involvement (i.e., vasculitis)
d. The age of the patient
55. In RA, vascular and parenchymal lesions suggest
that lesions result from injury induced by immune
complexes, especially those containing antibodies
to:
a. IgM
b. IgG
c. IgE
d. IgD
56. Serum complement levels are usually _______ in
patients with rheumatoid arthritis.
a. Normal
b. Decreased
c. Increased
d. a or b
57. The most common form of juvenile idiopathic
arthritis is:
a. Systemic
b. Oligoarthritis
c. Psoriatic
d. Enthesitis-related
58. In the RF agglutination procedure, a false-positive
result may be observed in a serum specimen
because of:
a. Complement interference
b. High levels of C-reactive protein (CRP)
c. Antigen excess
d. Hemolysis
59. In rapid testing for rheumatoid factor, biological
falsepositive results can be caused by a variety of
disorders including:
a. Infectious mononucleosis
b. Hepatitis
c. Systemic lupus erythematosus
d. Either b or c
60. Graft-versus-host disease is most frequently
associated with which transplant?
a. Cornea
b. Bone marrow
c. Bone matrix
d. Lung
61. The immune system functions in a detrimental
way in:
a. Hypersensitivity reactions
b. Autoimmunity
c. Transplantation
d. All of the above
62. The probability of success in organ and tissue
transplantation increases as a result of:
a. Histocompatibility testing
b. Immunosuppression
c. Surgical technique
d. Both a and b
63. The D region of the major histocompatibility
complex (MHC) codes for class ________
molecules.
a. I
b. II
c. III
d. IV
64. Class I includes HLA-________ antigens.
a. A, B, and C
b. B, C, and D
c. DR, DC(DQ), and A
d. DR, DC(DQ), and SB
[Type here]
65. Class I molecules:
a. Regulate interaction between cytolytic T cells
and target cells.
b. Restrict activity of regulatory T cells and target
cells.
c. Regulate interaction between helper T cells and
antigen-presenting cells.
d. Represent components of the complement
pathways.
66. The 1-year survival for kidney transplantation
from HLA-identical siblings approaches:
a. 50%.
b. 75%.
c. 95%.
d. 100%.
67. The most common form of bone marrow
transplant is:
a. Allogeneic
b. Autologous
c. Xenograft
d. Syngraft
68. Potential GVHD has all the following
characteristics except:
a. Source of immunocompetent T lymphocytes
b. Source of immunocompetent B lymphocytes
c. HLA differences between patient and recipient
d. Inability to reject donor cells
69. In GVHD posttransfusion, symptoms begin within
________ day(s) after transfusion.
a. 1
b. 2 to 4
c. 3 to 5
d. 3 to 30
70. GVHD can be prevented by:
a. Irradiating the patient pretransfusion
b. Irradiating the blood component pretransfusion
c. Administering antibiotics pretransfusion
d. Administering steroids posttransfusion
71. 2The mainstay of immunosuppression therapy in
transplantation is:
a. Azathioprine
b. Corticosteroids
c. Cyclosporine
d. Antilymphocyte globulin
72. The following diseases are treatable by stem cell
transplantation:
a. Acute lymphoblastic leukemia and acute
myelogenous leukemia
b. Aplastic anemia and non-Hodgkin’s lymphoma
c. Severe combined immunodeficiency disease
and chronic myeloid leukemia
d. All of the above
73. Progenitor blood cells are:
a. Pluripotent
b. Found only in bone marrow
c. Not useful in reconstituting a person’s immune
system
d. Determined by the exact number of CD34+ and
stem cell
74. Radiotherapy is most often used for:
a. Myelodysplastic syndrome
b. Localized solid tumors
c. Hodgkin’s disease
d. Both b and c
75. Pretransplantation evaluation includes:
a. HLA tissue typing and hepatitis screening
b. Electrocardiography and CBC
c. Bone marrow biopsy and complete history,
including physical examination
d. All of the above
76. Bone marrow is usually aspirated from:
a. Sternum
b. Anterior iliac crest
c. Posterior iliac crest
d. Vertebrae
77. Peripheral blood stem cells (PBSCs) are obtained
by:
a. Phlebotomy
b. Apheresis
c. Leukapheresis
d. Both b and c
78. Engraftment of bone marrow or PBSCs is:
a. Cell production in the bone marrow
b. Matching the donor and patient
c. Measured by the number of lymphocytes in
circulation
d. Antibody production
[Type here]
79. Complications of bone marrow or PBSC
transplantation include:
a. Infection and graft-versus-host disease (GVHD)
b. Acute rejection and organ damage
c. Chronic rejection and death
d. All of the above
80. Differences between donor and recipient’s ABO or
Rh blood groups have _______ effect on marrow
engraftment.
a. No
b. Some
c. A major
d. A total
81. Stem cell selection can be improved using the
CD_______ cell surface marker.
a. 4+
b. 8+
c. 34+
d. 56+
82. Increased cell selection and purging of grafts using
cell surface membrane markers has resulted in:
a. Decreased risk of tumor reinfusion
b. Lesser GVHD
c. Transfusing fewer erythrocytes as contaminants
d. All of the above
83. Toxicity associated with infusion of cryopreserved
products is mainly caused by: \
a. Dimethyl sulfoxide (DMSO)
b. Pentastarch
c. Human albumin
d. Glycerol
b. Pregnancy after 30 years of age
c. Use of estrogen (oral contraceptives or
hormone replacement)
d. All of the above
87. The cells involved in the immune response to
tumors are:
a. T lymphocytes, B lymphocytes, and
macrophages
b. Cytotoxic T lymphocytes, NK cells, and
macrophages
c. Neutrophils, lymphocytes, and monocytes
d. CD8+ lymphocytes, monocytes, and basophils
88. Which of the following is not an environmental
factor associated with carcinogenesis?
a. Ultraviolet light
b. Organically grown herbs
c. Benzene
d. Asbestos
89. The risk factor associated with the development
of basal cell carcinoma or malignant melanoma is:
a. Infrared light
b. Sunless tanning lotions
c. Ultraviolet light
d. Strobe lights
90. Patients with Down syndrome have a higher
incidence of:
a. Leukemia
b. Breast cancer
c. Prostate cancer
d. Teratomas
84. Benign tumors are characterized as:
a. Growing slowly
b. Resembling the parent tissue
c. Usually invading tissues (metastasizing)
d. Both a and b
91. Tumor cells typically carry _______ genetic
change(s).
a. One
b. Two
c. Three to six
d. Multiple
85. Which of the following factors is not a risk factor
in the development of cancer?
a. Smoking
b. Low-fat diet
c. Obesity
d. Sedentary lifestyle
92. 1Cancer-predisposing genes may:
a. Affect a host’s ability to repair damage to DNA
b. Increase cell cohesiveness
c. Decrease cell motility
d. Enhance the host’s immune ability to recognize
and eradicate incipient tumors
86. Risk factors associated with breast cancer include:
a. First-degree family history of breast cancer
93. Oncogenes are:
a. Genetic targets of carcinogens
[Type here]
b. Altered versions of normal genes
c. Detectable in 15% to 20% of a variety of human
tumors
d. All of the above
94. Which of the following is used to determine the
risk of developing cancer?
a. p53 gene
b. c-erbB-2 gene
c. Squamous cell carcinoma antigen
d. Epidermal growth factor receptor (EGFR)
95. A tumor marker assay is most useful:
a. To screen patients for malignancies
b. To monitor a cancer patient for disease
recurrence
c. To determine the degree of tumor burden
d. All of the above
96. Carcinoembryonic antigen is:
a. An oncofetal protein, elevated in some types of
cancer, that is found on normal fetal endocrine
tissue in the second trimester of gestation
b. An elevated oncofetal protein, strongly
correlated with various malignancies, that is
found on normal fetal endocrine tissue in the
second trimester of gestation
c. Used clinically to monitor tumor progress in
some types of patients, persistently elevated even
in residual disease or poor therapeutic response
d. Both b & c
97. Alpha-fetoprotein (AFP):
a. Is synthesized by the fetal liver and yolk sac
b. Can be elevated in some nonneoplastic
conditions
c. Is a very reliable marker for monitoring a
patient’s response to chemotherapy and radiation
therapy
d. All of the above
98. β-hCG is not:
a. Elevated in normal pregnancy
b. A sensitive tumor marker
c. Elevated in squamous cell carcinoma of the lung
d. Elevated in teratocarcinoma and
choriocarcinoma
99. Prostate-specific antigen is:
a. Prostate tissue–specific
b. Prostate cancer–specific
c. Not useful for monitoring response to therapy
in patients with prostate cancer
d. Not directly proportional to tumor volume in
prostate malignancies
100.
Which tumor marker is used to monitor
patients with breast cancer for recurrence of
disease?
a. CA 15-3
b. Estrogen receptor (ER)
c. Cathepsin-D
d. CA 50
101.
Tamoxifen acts as a(an) _______
pharmaceutical agent.
a. Cell cycle active, phase-specific
b. Non–cell cycle active
c. Estrogen receptor–blocking
d. Both b and c
102.
Active host immunotherapy responses may
be achieved by:
a. Transferring immune cells into host.
b. Vaccination with killed tumor cells.
c. Administration of tumor-specific MAbs.
d. Administration of IFN-α.