Review In Clinical Immunology & Serology

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 Review In Clinical Immunology & Serology
This examination covers the basics of Immunology and Serology that a Medical Technology student must know. This 70-item exam has a time limit of 60 minutes only. Please enter your name in the required field.

  
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  • 1. 
    Which of the following is not true?
    • A. 

      A hapten when combined with a carrier can elicit the formation of antibodies.

    • B. 

      Complete Freund' s Adjuvant can stimulate cellular immunity.

    • C. 

      IgG is the best complement fixing immunoglobulin.

    • D. 

      Anaphylaxis is an immediate hypersensitivity reaction that causes bronchoconstriction.


  • 2. 
    Which of the following domains is considered to be the foot of IgE?
    • A. 

      CH1

    • B. 

      CH2

    • C. 

      CH3

    • D. 

      CH4


  • 3. 
    What type of immunity develops during convalescence from an infection?
    • A. 

      Natural active immunity

    • B. 

      Natural passive immunity

    • C. 

      Artificial active immunity

    • D. 

      Artificial passive immunity


  • 4. 
    The best way to differentiate B cells from T cells is that
    • A. 

      B cells show characteristic formation called "rosette" around sheep erythrocytes.

    • B. 

      Lipopolysaccharides from gram negative bacteria enhance the mitosis of T cells.

    • C. 

      Surface membrane immunoglobulins are present on B cells.

    • D. 

      T cells have three subtypes while B cells whave only two subtypes.


  • 5. 
    The coating of particulate antigen by antibody and/or complement components that allows them to be more phagocytized readily is called:
    • A. 

      Immune adherence

    • B. 

      Complement fixation

    • C. 

      Opsonization

    • D. 

      Immune complex formation


  • 6. 
    Which of the following is correct?
    • A. 

      The method of complement assay that involves the measurement of precipiting ring diameter after 48 hours is Fahey McKelvey.

    • B. 

      Type I hypersensitivity is known as the "cytotoxic type" .

    • C. 

      CD19,CD20,and CD21 are subtypes of B cells.

    • D. 

      The C5 convertase in the Classical Pathway of complement activation is C4b2b3b.


  • 7. 
    Which of the following plays an important role as an external defense mechanism?
    • A. 

      Phagocytosis

    • B. 

      CRP

    • C. 

      Lysozyme

    • D. 

      Complement


  • 8. 
    MHC molecules are associated with which of the following?
    • A. 

      Graft rejection

    • B. 

      Autoimmune diseases

    • C. 

      Determining to which agents an individual responds

    • D. 

      All of the above


  • 9. 
    All of the following are characteristic of a good immunogen except
    • A. 

      Internal complexity

    • B. 

      Large molecular weight

    • C. 

      The presence of numerous epitopes

    • D. 

      Found on host cells


  • 10. 
    Which of the following is characteristic of the endpoint method of RID?
    • A. 

      Readings are taken before equivalence is reached.

    • B. 

      Concentration is directly proportional to the square of the diameter.

    • C. 

      The diameter is plotted against the log of the concentration.

    • D. 

      It is primarily a qualitative rather than a quantitative method.


  • 11. 
    Agglutination of dyed bacterial cells represents which type of reaction?
    • A. 

      Direct agglutination

    • B. 

      Passive agglutination

    • C. 

      Reverse passive agglutination

    • D. 

      Agglutination inhibition


  • 12. 
    A positive direct Coomb's test would occur under which circumstances?
    • A. 

      Hemolytic disease of the newborn

    • B. 

      Autoimmune hemolytic anemia

    • C. 

      Antibodies to drugs that bind to red cells

    • D. 

      Any of the above


  • 13. 
    How much diluent needs to be added to 0.2mL of serum to make a 1:20 dilution?
    • A. 

      19.8 mL

    • B. 

      4.0 mL

    • C. 

      3.8 mL

    • D. 

      10.0 mL


  • 14. 
    All of the following are true of IgM except that it
    • A. 

      Can cross the placenta

    • B. 

      Fixes complement

    • C. 

      Has a J chain

    • D. 

      Is a primary response antibody


  • 15. 
    If cells of an individual are not agglutinated by serum from anyone else, this represents which Lansteiner blood type?
    • A. 

      Type A

    • B. 

      Type B

    • C. 

      Type O

    • D. 

      Type AB


  • 16. 
    Metchnikoff first described which of the following?
    • A. 

      Phagocytosis

    • B. 

      Variolation

    • C. 

      Humoral immunity

    • D. 

      Opsonization


  • 17. 
    The inflammatory process is characterized by all of the following except
    • A. 

      Increased blood supply to the area

    • B. 

      Migration of white blood cells

    • C. 

      Decreased capillary permeability

    • D. 

      Appearance of acute phase reactants


  • 18. 
    In an agglutination reaction, if cells are not centrifuged long enough, which of the following might occur?
    • A. 

      False-negative result

    • B. 

      False-positive result

    • C. 

      No effect

    • D. 

      Slight but can be ignored


  • 19. 
    The density gradient solution used for the separation of lymphocytes
    • A. 

      Roswell Park Memorial Institute

    • B. 

      Ficolle medium

    • C. 

      Phosphate buffered saline

    • D. 

      Normal saline solution (0.9% NaCl)


  • 20. 
    The purpose of serum inactivation is/are
    • A. 

      To destory the native complement

    • B. 

      To remove heat labile anti-complementary substances

    • C. 

      To stabilize the serologic properties of the serum

    • D. 

      All of the above


  • 21. 
    Inactivation of serum is done by heating at ____ for ____.
    • A. 

      56 degrees Celsius, 30 minutes

    • B. 

      56 degrees Celsius, 10 minutes

    • C. 

      65 degrees Celsius, 20 minutes

    • D. 

      65 degrees Celsius, 10 minutes


  • 22. 
    Which of the following reagents is used to cleave a polymeric antibody at the J chain resulting to monomers?
    • A. 

      Papain

    • B. 

      Pepsin

    • C. 

      Sodium polyanethol

    • D. 

      Dithiothreitol


  • 23. 
    Diabetes mellitus can be detected by typing HLA of class
    • A. 

      I

    • B. 

      II

    • C. 

      III

    • D. 

      IV


  • 24. 
    The exact binding site of an antigen is called its
    • A. 

      Epitope.

    • B. 

      Paratope.

    • C. 

      Valence.

    • D. 

      Any of the above


  • 25. 
    Which of the following is true about RPR and VDRL?
    • A. 

      Serum inactivation is required.

    • B. 

      These are examples of indirect agglutination tests.

    • C. 

      Both are classified as TTT.

    • D. 

      These are non-specific for syphilis.


  • 26. 
    Skin, lactic acid secretions, stomach acidity, and the motion of cilia represent which type of immunity?
    • A. 

      Natural

    • B. 

      Acquired

    • C. 

      Adaptive

    • D. 

      Auto


  • 27. 
    Which of the following is a primary lymphoid organ?
    • A. 

      Lymph node

    • B. 

      Spleen

    • C. 

      Thymus

    • D. 

      Mucosal associated lymphoid tissue


  • 28. 
    Which of the following antigens are found on the T cell subset known as "inducers"?
    • A. 

      CD3

    • B. 

      CD4

    • C. 

      CD8

    • D. 

      CD11


  • 29. 
    Which of the following are found on a mature B cell?
    • A. 

      IgG and IGD

    • B. 

      IgM and IgD

    • C. 

      Alpha and beta chains

    • D. 

      CD3 and CD4


  • 30. 
    Bence Jones proteins are identical
    • A. 

      H chains

    • B. 

      IgM molecules

    • C. 

      L chains

    • D. 

      IgG molecules


  • 31. 
    a 4% solution of RBC is needed for diagnostic testing in the laboratory. What dilution of packed red blood cells does this represent?
    • A. 

      1:25

    • B. 

      1:4

    • C. 

      1:96

    • D. 

      4:1


  • 32. 
    The most specific cells containing antigens that agglutinate with heterophile antibodies are
    • A. 

      Human erythocytes

    • B. 

      Horse erythrocytes

    • C. 

      Sheep erythrocytes

    • D. 

      B and C


  • 33. 
    IgG is sometimes referred to as incomplete antibody because
    • A. 

      It is only active at 25 degrees Celsius.

    • B. 

      It may be to small to produce lattice formation.

    • C. 

      It only has one antigen-binding site.

    • D. 

      It is not able to prodice visible in vivo agglutination.


  • 34. 
    What is the immune mechanism involved in Type III hypersentivity reaction?
    • A. 

      Cellular antigens are involved.

    • B. 

      Deposition of immune complexes occurs in atibody excess.

    • C. 

      Only heterologous antigens are involved.

    • D. 

      Tissue damage results from exocytosis.


  • 35. 
    Which of the following would cause a false-negative result in DAT?
    • A. 

      Incubating longer than 5 minutes.

    • B. 

      Not washing red cells thoroughly.

    • C. 

      Using EDTA anticoagulated blood.

    • D. 

      Presence of IgG on red cells.


  • 36. 
    Which of the following intradermal neutralization tests is used to diagnose diphtheria?
    • A. 

      Dick's test

    • B. 

      Casoni test

    • C. 

      Bachman test

    • D. 

      Schick's test


  • 37. 
    The end of cell mediated immunity is
    • A. 

      Phagolysosome formation

    • B. 

      Exocytosis

    • C. 

      Antigen epitope presentation by HLA

    • D. 

      Lysosome formation


  • 38. 
    Which of the following is true?
    • A. 

      The specimen for Class II HLA typing is pure B cells.

    • B. 

      The specimen for RID C3c assay is inactivated serum.

    • C. 

      Eosin is added to neutrophil-bacterial suspension in the intacellular killing assay.

    • D. 

      In the ABO blood group system, serum typing is an example of an indirect agglutination reaction.


  • 39. 
    Which of the following is incorrect?
    • A. 

      NBT dye is colored yellow-orange when added to inactive neutrophils.

    • B. 

      A green fluorescence seen on a fluorescence microscope after addition of acridine orange represent alive organisms.

    • C. 

      CD4 receptors are responsible for the rosette formation of sheep erythrocytes.

    • D. 

      Proteus organisms are used as antigens for Weil Felix test.


  • 40. 
    All of the following are trye of IgE except that it
    • A. 

      Fails to fix complement

    • B. 

      Is heat stable

    • C. 

      Attaches to tissue mast cells

    • D. 

      Is found in the seurm of allergic persons


  • 41. 
    Which of the following are L chains of an antibody molecule?
    • A. 

      Kappa

    • B. 

      Gamma

    • C. 

      Mu

    • D. 

      Alpha


  • 42. 
    the structure formed by the fusion of engulfed materials and enzymatic granules whithin a phagocytic cell is called a
    • A. 

      Phagosome.

    • B. 

      Vacuole.

    • C. 

      Lysosome.

    • D. 

      Phagolysosome.


  • 43. 
    What is the advantage of VDRL over RPR?
    • A. 

      Reactions in VDRL can be seen macroscopically as dense flocculates.

    • B. 

      CSF can be used as a specimen for VDRL.

    • C. 

      Serum inactivation is not needed in VDRL.

    • D. 

      All of the above


  • 44. 
    Which of the following can be attributed to antigen-stimulated T cells?
    • A. 

      Humoral response

    • B. 

      Plasma cells

    • C. 

      Cytokines

    • D. 

      Antibody


  • 45. 
    Which represents the main function of IgD?
    • A. 

      Protection of the mucous membranes

    • B. 

      Removal of antigens by complement fixation

    • C. 

      Enhancing the proliferation of B cells

    • D. 

      Destruction of parasitic worms


  • 46. 
    All of the following are true of the recognition unit except that
    • A. 

      It consists of C1q, C1r, and C1s.

    • B. 

      The subunits require calcium for binding together.

    • C. 

      It is a part of the Properdin Pathway.

    • D. 

      C1q activates C4.


  • 47. 
    The CH50 test measures which of the following?
    • A. 

      The dilution of patient serum required to lyse 50 percent of a standard concentration of sensitized sheep red blood cells

    • B. 

      Functioning of both the classical and alternative pathway

    • C. 

      Genetic deficiencies of any of the complement components

    • D. 

      All of the above


  • 48. 
    Flagellar antigens are designated
    • A. 

      "O" antigens

    • B. 

      "K" antigens

    • C. 

      "H" antigens

    • D. 

      "Vi" antigens


  • 49. 
    In an Ouchterlony immunodiffusion reaction with antigens 1 and 2, if crossed lines result, what does this indicate?
    • A. 

      Antigens 1 and 2 are identical.

    • B. 

      Antigen 2 is simpler than antigen 1.

    • C. 

      Antigen 2 is more complex than anitgen 1.

    • D. 

      The two antigens are unrelated.


  • 50. 
    The most abundant circulating antibody in human plasma is
    • A. 

      IgG

    • B. 

      IgM

    • C. 

      IgD

    • D. 

      IgE

    • E. 

      IgA


  • 51. 
    Who developed the Side Chain Theory of antibody formation?
    • A. 

      Ehrlich

    • B. 

      Haurowitz and Breini

    • C. 

      Jerne and MacFarlane

    • D. 

      Claman


  • 52. 
    Which of the following statemens is correct?
    • A. 

      Humoral immunity primarily involves B lymphocytes.

    • B. 

      The variable region of an antibody molecule is responsible for its sensitivity.

    • C. 

      Complement components are under Class II of HLA molecules.

    • D. 

      None of the above


  • 53. 
    TDT-positive cells are
    • A. 

      Pluripotential stem cells

    • B. 

      Lymphoid stem cells

    • C. 

      Pre-B cells

    • D. 

      Myeloid stem cells


  • 54. 
    In the separation of b and T cells by the nylon wool technique,
    • A. 

      SMIg+ B cells adhere to the nylon wool and are therefore eluted last.

    • B. 

      SMIg- B cells adhere to the nyloon wool and are therefore eluted first.

    • C. 

      SMIg+ T cells adhere to the nylon wool and are therefore eluted last.

    • D. 

      SMIg+ T cells adhere to the nylon wool and are therefore eluted first.


  • 55. 
    The Classical Pathway of complement activation is specific because
    • A. 

      Immune complexes activate the pathway.

    • B. 

      Cobra venom factor, aggregated IgA's,and baterial LPS activate the pathway.

    • C. 

      A and B

    • D. 

      None of the above


  • 56. 
    A negative test for VDRL but positive for FTA-ABS correlate with which of the following clinical finding?
    • A. 

      SLE

    • B. 

      Early syphilis

    • C. 

      Biologic false positive reaction

    • D. 

      IM


  • 57. 
    Reaginic antibodies are
    • A. 

      IgG

    • B. 

      IgM

    • C. 

      IgD

    • D. 

      IgE

    • E. 

      IgA


  • 58. 
    Which of the following is considered to be the third line of defense against pathogens?
    • A. 

      Intact skin

    • B. 

      Phagocytosis

    • C. 

      Cell mediated immunity

    • D. 

      Humoral immunity


  • 59. 
    The following adjuvant stimulate T cells except
    • A. 

      SMDP

    • B. 

      GNB

    • C. 

      Complete Freund's Adjuvant

    • D. 

      None of the above


  • 60. 
    Active immunity occurs in the administration of
    • A. 

      Immune serum

    • B. 

      Toxoid

    • C. 

      A or B

    • D. 

      None of the above


  • 61. 
    A graft from a mother to her child would be a/an
    • A. 

      Xenograft

    • B. 

      Autograft

    • C. 

      Allograft

    • D. 

      Syngeneic graft

    • E. 

      Heterograft


  • 62. 
    Positive titer of 1/160 for OX19 Proteus antigen is considered significant in
    • A. 

      Rocy Mountain Spotted Fever

    • B. 

      Trench fever

    • C. 

      Rickettsial pox

    • D. 

      Tsutsugamushi fever


  • 63. 
    Serologic diagnosis for cryptococcus can be made by testing what specimen/s?
    • A. 

      Urine

    • B. 

      CSF

    • C. 

      Serum

    • D. 

      All of the above


  • 64. 
    Carcinoembryonic antigen is correlated with
    • A. 

      Colon cancer

    • B. 

      Ovarian cancer

    • C. 

      Prostate cancer

    • D. 

      Hepatoma


  • 65. 
    FIA was performed on a specimen form a patient with SLE. The pattern on the fluorescence microscope would be
    • A. 

      Homogenous or solid

    • B. 

      Peripheral or rim

    • C. 

      Speckled

    • D. 

      Nucleolar


  • 66. 
    Graft versus host disease is most commonly associated with which transplant?
    • A. 

      Bone marrow

    • B. 

      Corneal

    • C. 

      Bone matrix

    • D. 

      Lung


  • 67. 
    Vi agglutination is correlated to patients harboring
    • A. 

      Escherichia coli

    • B. 

      Proteus spp.

    • C. 

      Brucella spp.

    • D. 

      Salmonella typhi


  • 68. 
    Cold agglutinnins are classed as
    • A. 

      IgM

    • B. 

      IgG

    • C. 

      IgA

    • D. 

      IgD

    • E. 

      IgE


  • 69. 
    A useful indicator of the relative infectivity of HBV is
    • A. 

      HBs Ag

    • B. 

      HBe Ag

    • C. 

      Anti-HBc

    • D. 

      Anti-HBe

    • E. 

      Anti-HBs


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