Immuno TB Flashcards Unit 3
1) A 10-year-old girl was brought in to her physician's office because she
had been complaining that she was thirsty and had to go to the
bathroom all the time. She had lost 15 pounds over the last 6 months
and was more irritable than usual, especially after meals. The girl's
fasting blood glucose was 575 mg/dL, her C-peptide was 0.5 ng/mL,
and she had autoantibodies against glutamic acid decarboxylase and
insulin. This girl has:
2) A 40-year-old woman presents with a lemon-yellow, waxy pallor and
a red, beefy tongue. She is extremely fatigued and is having difficulty
getting up in the morning and getting through the day. Antiparietal cell
antibodies are found in her serum. This woman has:
3) A 56-year-old woman presents to her physician complaining of weight
gain and joint problems. She is increasingly having difficulty walking
up stairs and manipulating her fingers. Fingers in both hands as well as
knees on both legs are equally painful and stiff. The symptoms have
been progressing over the last 6 months. Rheumatoid factor is
elevated, and antinuclear antibodies are not detected. Complement
levels in her joints are less than the levels in her serum. This woman
has:
4) A 30-year-old clinical laboratory sciences student complains of being
tired, yet not able to sleep. The woman also states that her hair has
been breaking off and she has lost 20 pounds over the last 2 months
without trying. The woman's pulse and blood pressure are both
elevated and her eyes seem to be bulging. Her CBC is normal, thyroidstimulating hormone is decreased, and T4 is increased.
Antimicrosomal and antithyroglobulin antibodies are each 1:400. This
woman has:
5) A 54-year-old woman presents to her optometrist complaining that she
has been having difficulty focusing on objects, both near and far. Her
vision problems are getting progressively worse. She also thinks that
her eyelids are drooping and she is thinking of getting plastic surgery
to “put them back up.” The optometrist cannot find a good reason for
her vision problems but is able to fit her with glasses and recommends
that she see a rheumatologist. The rheumatologist sends the women's
blood for autoantibody testing, and the laboratory professionals report
that the woman has autoantibodies against the acetylcholine receptor.
This woman has:
6) A 33-year-old female presents with red and irritated eyes for the last
month. Discharge from the eyes is not apparent. She also has had
recurrent low-grade fever and a rash on her chest and legs. Her joints
have been achy for the last few months, and her mouth has been so dry
it is often difficult to swallow food. Antinuclear antibody testing is
performed, and a speckled pattern is observed on hep-2 cells. Followup testing reveals the presence of autoantibodies against SS-A and SSB. This woman has:
7) A 45-year-old male presents to his physician complaining of achy
type 1 diabetes
pernicious anemia
rheumatoid
arthritis
Graves' disease
myasthenia gravis
Sjögren's
syndrome
Wegener's granulomatosis
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Immuno TB Flashcards Unit 3
joints, chronic runny nose, and coughing up blood. Chest x-ray shows
pulmonary nodules. Cortisol is increased; ESR is slightly elevated.
Tests for autoantibodies are positive for cytoplasmic antineutrophil
cytoplasmic antibodies. This patient has:
8) The “CREST” variant of which disease is associated with the presence
of an anticentromere antibody?
9) A 40-year-old female patient has increased TSH and decreased rT3
and T4 levels with a normal T3 level. Antithyroglobulin is measured
as 1:1280, and the antimicrosomal level is reportedly 1:6400. This
patient most likely has:
10) What lab findings would be most likely to indicate multiple sclerosis?
11) Systemic lupus erythematosus can be characterized by all of the
following EXCEPT:
A) butterfly rash
B) joint pain
C) presence of circulating immune complexes
D) presence of reagin antibody
12) In the slide agglutination for lupus, what is detected?
13) An autoimmune disease characterized by pain and progressive
destruction of the joints, weight loss, morning stiffness, and presence
of an antibody directed against IgG best describes:
14) Reasons for autoimmunity may include all of the following EXCEPT:
A) inheritance of certain HLA antigens
B) molecular mimicry
C) polyclonal B cell activation
D) normal antibody production
15) The characteristic ANA pattern produced by antibody to DNA-histone
complex is:
16) A disease characterized by hypoactivity of the thyroid with weight
gain and a sluggish metabolism due to destruction of thyroglobulin
best describes:
17) In the RF test for rheumatoid arthritis, what is being detected?
18) 18. What are characteristic of cold autoimmune hemolytic anemia?
19) The fluorescent antinuclear antibody test for lupus is an example of
what?
20) What would be an indicator of systemic lupus?
21) In which one of the following autoimmune diseases are antibodies to
acetylcholine receptors produced, thereby blocking the signal to
muscles?
22) Lupus can be distinguished from rheumatoid arthritis on the basis of
what?
progressive
systemic sclerosis
(scleroderma)
Hashimoto's
thyroiditis
several bands on
electrophoresis of
CSF
D
anti-DNP
rheumatoid
arthritis
D
homogeneous
Hashimoto's
thyroiditis
IgM directed
against IgG
The antibody
reacts as an anti-I.
indirect fluorescent
testing
anti-Sm antibody
myasthenia gravis
deposition of
immune
2
Immuno TB Flashcards Unit 3
complexes in the
kidney
rheumatoid
arthritis
23) A 25-year-old female sees her physician because of swelling in the
joints of her hands and generally feeling tired and run down. A slide
agglutination test for antibody directed against IgG is positive. What is
the most likely cause of her symptoms?
24) Antibodies directed against thyroglobulin represent a significant
Hashimoto's
finding in what autoimmune diseases?
thyroiditis
25) What would be an indicator of systemic lupus?
antideoxynucleoprotei
n antibody
26) A 35-year-old female experiences difficulty in walking, and her hands multiple sclerosis
and feet are numb from time to time. Suspecting a disease involving
the central nervous system, her physician orders an MRI. The MRI
reveals lesions on the myelin sheath. What is the most likely disease?
27) All of the following findings would be useful in the diagnosis of
D
Graves' disease EXCEPT:
A) presence of antibodies to thyroid-stimulating hormone receptors
B) hyperthyroidism
C) symptoms of nervousness and weight loss
D) increase in allergic IgE
28) Homogeneous staining of the nucleus in an ANA test indicates:
antibody to DNAhistone complex
29) A 16-year-old male goes to his physician for an annual checkup. A
Goodpasture's
routine urinalysis indicates the presence of blood, an increase in
syndrome
protein, and an increase in urea. The young man reports that he has
been feeling tired and has a persistent cough. The doctor orders
additional lab testing, including a serum test for rheumatoid factor,
antinuclear antibody testing, anti-streptolysin O testing, and testing for
the presence of anti-basement membrane antibodies. Only the latter
test was positive. What is the most likely cause of the symptoms?
30) A CBC, differential, and flow cytometry were performed on a patient
B-cell chronic
with the following results (normal values): WBC = 8.0 th/uL (5.0–10.0 leukemia
th/uL), diff = 90% lymphs (20–40%), CD3 = 5% (60–80%), CD5 =
95% (60–80%), CD19 = 95% (5–20%), CD10 = 0% (0%), surface Ig
= pos (positive), and cytoplasmic Ig = neg (negative). What disease
does this patient have?
31) What is the interpretation of the following patient results? (normal
T-cell chronic
values) WBC = 90.0 th/uL (5.0–10.0 th/uL,), with 89% lymphs (20–
leukemia
40%); CD3 = 90% (60–80%); CD5 = 87% (60–80%); CD10 = 0% (<
1%); CD4 = 88% (30–65%); CD20 = 12% (5–20%); CD34 = 0% (<
1%); CD8 = 3% (10–40%); kappa = 10% (3–15%); lambda = 5% (2–
10%); CD19 = 15% (5–20%).
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Immuno TB Flashcards Unit 3
32) What is the interpretation of the following patient results? (normal
values) WBC = 25.0 th/uL (5.0–10.0 th/uL), with 78% blasts; CD3 =
83% (60–80%); CD5 = 90% (60–80%); CD10 = 2% (< 1%); CD4 =
85% (30–65%); CD20 = 1% (5–20%); CD34 = 0% (< 1%); CD8 =
87% (10–40%); kappa = 1% (3–15%); lambda = 0% (2–10%); CD19
= 2% (5–20%).
33) What is the interpretation of the following patient results? (normal
values) WBC = 7.0 th/uL (5.0–10.0 th/uL), with 89% blasts; CD3 =
10% (60–80%); CD5 = 9% (60–80%); CD10 = 89% (< 1%); CD4 =
6% (30–65%); CD20 = 0% (5–20%); CD34 = 94% (< 1%); CD8 = 3%
(10–40%); kappa = 0% (3–15%); lambda = 0% (2–10%); CD19 =
90% (5–20%).
34) Which immunoproliferative disorder is a cancer of the plasma cells
and results in secretion of light chains into the urine?
35) A 55-year-old male presents with symptoms that include weakness,
loss of appetite, and anemia. Immunofixation electrophoresis reveals a
heavy IgM band. What is the most likely diagnosis?
36) What is the main difference between leukemias and lymphomas?
37) What best describes the difference between chronic and acute
lymphocytic leukemias?
38) Decreased CD3-positive lymphocytes and a lack of responsiveness to
phytohemagglutinin (PHA) in the circulation would typically be
associated with:
39) What statements about severe combined immunodeficiency (SCID)
are true?
40) A 9-month-old boy was suspected of having an immune deficiency
because he had many recurrent infections with Streptococcus
pneumoniae. Laboratory tests revealed a normal percentage of T cells
and T-cell subsets but a lack of mature B cells and immunoglobulins.
This boy most likely has:
41) A patient with hereditary angioedema will present with swelling in the
tissues and has what deficiencies?
42) A 7-month-old boy is seen by a specialist because of hypocalcemia,
viral pneumonia, a history significant for recurrent diarrhea, and oral
candidiasis. An x-ray reveals the lack of a thymic shadow. This boy
most likely has:
43) An autosomal recessive disease characterized by the presence of
abnormally large granules primarily affecting the function of
lysosomes is known as:
T-cell acute
leukemia
B-cell acute
leukemia
multiple myeloma
Waldenström's
macroglobulinemia
Lymphomas arise
mainly in lymph
nodes, the spleen,
or other lymphoid
tissue.
Acute lymphocytic
leukemias have a
high response rate
to chemotherapy.
DiGeorge
syndrome
may be associated
with a signal
transduction defect
X-linked
agammaglobuline
mia
C1 inhibitor
DiGeorge
syndrome
Chédiak-Higashi
syndrome
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Immuno TB Flashcards Unit 3
44) A child suspected of having an inherited humoral immunodeficiency
disease is given diphtheria/tetanus vaccine. Two weeks after the
immunization, his level of antibody to the specific antigens is
measured. Which result is expected for this patient if he does have this
deficiency?
45) Which disease may be expected to show an IgM spike on an
electrophoretic pattern?
46) What diseases results in an acquired or secondary immunodeficiency?
47) A 1-year-old boy is evaluated for a suspected immune deficiency. He
has a history since birth of eczema, recurrent rashes, and diarrhea.
(Normal values are given in parentheses.) His WBC count is 6.75/uL
(5.0–10.8 × 103 uL) with a normal differential. Platelet count is
35,000 (150,000–350,000/uL) and the platelets are small. His IgG is
750 mg/dL (600–1,500 mg/dL), IgM is 30 mg/dL (75–150 mg/d :),
IgA is 475 mg/dL (50–125 mg/dL), and IgE is 750 mg/dL (10–50
mg/dL). The boy's blood is typed as O-positive, and he does not have
anti-A or anti-B antibodies. Flow cytometry performed on his blood
shows 11% (5–20%) CD19 and 50% (60–80%) CD3 cells with a
normal ratio of CD4:CD8. T-cell function tests are abnormal. This boy
most likely has:
48) A 2-week-old girl is evaluated by a specialist because her physical
appearance is abnormal. She has been hospitalized since birth.
(Normal values are given in parentheses.) Her CD3 level is reported as
15% (60–80%), CD4 = 10% (30–65%), CD8 = 5% (10–40%), and
CD19 = 84% (5–20%). Serum immunoglobulin levels are normal.
Karyotyping reveals a deletion on chromosome 22. This girl has:
49) A 9-month-old infant is seen by a physician due to a persistent skin
infection. His white and red blood cell counts are normal. However,
immunofixation electrophoresis indicates a low level of IgG. When
the infant returns to the physician for a follow-up visit in a month, his
IgG level has increased. What condition do these results indicate?
50) A 6-month-old baby has suffered from recurrent bacterial infections.
Flow cytometry results indicate a lack of B cells but presence of
normally functioning T cells. Which is the most likely diagnosis?
51) Which is true of selective IgA deficiency?
52) What best describes common variable immunodeficiency disease?
53) A male baby who has suffered from persistent Candida fungal
infections and several bouts of pneumonia all before the age of 6
months is found to have some developmental problems as well as lowset ears. Lab testing reveals an absence of T cells. What is the most
likely diagnosis?
no change in the
level of specific
antibody
Waldenström's
macroglobulinemia
HIV infection
Wiskott-Aldrich
syndrome
DiGeorge
syndrome
transient
hypogammaglobuli
nemia
Bruton's
agammaglobuline
mia
Patients may
develop an antiIgA antibody.
There is a
deficiency of IgA
and/or IgG.
DiGeorge
syndrome
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Immuno TB Flashcards Unit 3
54) What is associated with DiGeorge syndrome?
55) The disease SCID is characterized by what?
56) A nitro-blue tetrazolium (NBT) test indicates little color in cells
observed under a microscope. What disease does this most likely
indicate?
57) Which term applies to the type of graft rejection that begins within a
few weeks or months after transplantation of an organ and is due to
CD8 reactive T cells?
58) Which antigens are most important in matching for tissue transplants?
59) A 25- year-old female is in kidney failure and needs a transplant. She
is A positive and HLA A1A3/B5B7/C2C9/DR4DR8. What donors
would be the best match?
A)
her brother, who is B positive and HLA
A1A3/B7B5/C2C9/DR8DR4
B)
her sister, who is A positive and HLA A3A4/B7B9/C2C3/DR4DR7
C)
her mother, who is AB positive and HLA
1A4/B9B5/C9C3/DR8DR7
D)
an unrelated donor who is A positive and HLA
A6A3/B5B7/C3C10/DR2DR9
60) The type of rejection that occurs within minutes to hours due to
preformed antibody is known as:
61) Graft-versus-host disease results under which conditions?
62) Transplantation of an individual's skin from one place to another is an
example of a(n):
63) When foreign HLA antigens are presented by antigen-presenting cells
to T cells, this is known as:
64) When a complement-dependent cytotoxicity test was performed using
standard antibodies to HLA A1, A3, B2, and B11, the following
microscopic results were obtained: a majority of blue cells were seen
with anti-A1, A3, and B11. Based on these results, what is the
phenotype of the donor cells?
65) Which test would be best to determine the actual genotype in an HLA
matching?
small or missing
thymus
diagnosed in
infancy, short life
span, no antibody
production
chronic
granulomatous
disease
chronic rejection
HLA A and B,
blood group
antigens A or B,
and HLA DR1 and
DQ1
B
hyperacute
rejection
when
immunocompetent
cells are placed in
an
immunocompromi
sed host
autograft
indirect
allorecognition
HLA A1, A3, B11
polymerase chain
reaction
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Immuno TB Flashcards Unit 3
66) How can normal cells become malignant?
67) A woman goes 3 days per week to a tanning bed for 20 minutes of UV
exposure per visit. Which stage of cancer is this?
68) If a disease is present in 1 in every 10,000 ndividuals, and a marker
can detect this disease with 100% sensitivity and 95% specificity,
what would be the number of false positives for each cancer found?
69) A tumor found in the prostate does not sstain with antibody to PSA. Is
this proof that the tumor came from a different organ?
70) Antibodies against streptolysin O, hyaluronidase, and DNase B are
measured in the diagnosis of which disease?
71) Acute glomerulonephritis is due to:
72) What bacterial enzymes causes the release of lysosomal contents into
the cytoplasm of the phagocytic cell, leading to the death of the cell?
73) An ASO test was performed on the serum from a 10-year-old female
patient with the following results: no hemolysis in the 1:10, 1:20, 1:40,
and 1:80 tubes; and hemolysis in the 1:160, 1:320, and 1:640 tubes.
What conclusion can you draw from these results?
74) What statements best describes Helicobacter pylori?
75) All of the following are tests used to identify Helicobacter pylori
EXCEPT:
A) polymerase chain reaction
B) urease
C) enzyme immunoassay
D) DNase
76) What is the main reason testing for cold agglutinins is no longer
recommended to diagnose infection with Mycoplasma pneumonia?
77) Organisms that are short rods or coccobacilli and obligate intracellular
bacteria best describes:
78) How does complement help in defense against bacterial invasion?
79) Antibodies detected by reacting rickettsial antigens with specific
antibody followed by use of an anti-immunoglobulin with a
fluorescent tag could be used to diagnose:
Overexpression of
oncogenes,
Underexpression
of tumorsuppressing genes,
Viral infection
Induction
5
No
rheumatic fever
deposition of
immune
complexes in the
kidney
leukocidin
The titer is 1:80,
and the patient is
normal.
It is a gramnegative spiral that
causes ulcers.
D
False-positives
may be caused by
certain viruses.
Rickettsia
prowazekii
It promotes
phagocytosis.
Rocky Mountain
spotted fever
7