Biomedical Laboratory Diagnostics
Final Exam Questions
Course Introduction
Biomedical Laboratory Diagnostics is an essential course that introduces students to the fundamental principles, techniques, and technologies used in the clinical laboratory setting to diagnose and monitor diseases. The course covers topics such as laboratory safety, sample collection and handling, quality control, and the operation of common diagnostic instruments. Students will also study the methodologies behind hematology, clinical chemistry, microbiology, immunology, and molecular diagnostics. Emphasis is placed on interpretation of test results, troubleshooting procedures, and the ethical responsibilities of laboratory professionals. Through both theoretical study and practical laboratory sessions, students gain the skills necessary to contribute to accurate diagnosis and patient care within healthcare environments.
Recommended Textbook
Clinical Immunology and Serology A Laboratory Perspective 3rd Edition by Christine Dorresteyn
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22 Chapters
562 Verified Questions
562 Flashcards
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Chapter 1: Introduction and Natural Immunity
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49 Flashcards
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Sample Questions
Q1) A protein that only changes in concentration significantly in response to inflammation and is not detectable when there is no inflammation is called a/an:
A) reagin
B) immunoglobulin
C) complement protein
D) acute phase protein
Answer: D
Q2) Which of the following is part of the external defense system?
A) ceruloplasmin
B) skin
C) neutrophils
D) complement
Answer: B
Q3) Neutrophils and macrophages use all of the following to kill bacteria EXCEPT:
A) H<sub>2</sub>O<sub>2</sub>
B) perforin
C) hydroxyl radical
D) lysozyme
E) superoxide anion
Answer: B
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Chapter 2: Lymphoid System
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Sample Questions
Q1) Which of the following surface markers are found on mature T cells?
A) IgM and IgD
B) IgG and IgA
C) CD19
D) CD3
Answer: D
Q2) In antibody-dependent cell-mediated cytotoxicity,target cells are recognized by which of the following?
A) T-cell receptor on the effector cell binding to Fab of IgG bound to the target cell
B) C-type lectin inhibitory receptors on effector cell binding to class I on target cell
C) CD16 on the effector cell binding to Fc of IgG bound to the target cell
D) CD154 on the effector cell binding to CD40 on the target cell
Answer: C
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4
Chapter 3: Nature of Antigens and Major Histocompatibility Complex
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Sample Questions
Q1) Endogenous peptides binding to HLA-A,B,or C molecules on the surface of hepatocytes is critical for the response by:
A) B lymphocytes
B) T helper cells
C) cytotoxic T cells
D) macrophages
Answer: C
Q2) Which of the following is a characteristic of HLA-DR,-DP,and -DQ molecules?
A) antigen receptors on all lymphocytes
B) antigen receptors on T lymphocytes
C) surface alloantigens on liver and kidney cells
D) expressed co-dominantly (maternal and paternal)
Answer: D
Q3) Which best describes a finding of Landsteiner's study of haptens?
A) Similar haptens trigger the same antibody response.
B) Spatial configuration is recognized by antibody.
C) Small chemical changes to a hapten do not affect antibody response.
D) A hapten can react with many different antibodies.
Answer: B
Page 5
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Chapter 4: Antibody Structure and Function
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Sample Questions
Q1) Which antibody is found in the greatest supply and is the only one capable of crossing the placenta?
A) IgA
B) IgD
C) IgE
D) IgG
Q2) The antibody found on mucosal surfaces that acts as a first line of defense is called:
A) IgA
B) IgD
C) IgE
D) IgM
Q3) Which of the following is true of coding for antibody molecules?
A) Heavy chains are coded for on chromosome 2.
B) V,D,and J code for heavy chain variable regions.
C) DNA coding for light chains are rearranged first.
D) V and D code for light chain variable regions.
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Chapter 5: Cytokines
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Sample Questions
Q1) The main target of interleukin-3 is:
A) antigen-activated B cells
B) antigen-activated T cells
C) macrophages
D) stem cells
Q2) Which cytokine is involved in natural immunity?
A) interleukin-6
B) interleukin-2
C) interleukin-4
D) interleukin-5
Q3) What is the function of TGF-\(\beta\)?
A) helps in antibody-mediated immunity
B) regulates cell growth and differentiation
C) inhibits IL-2
D) acts as an endogenous pyrogen
Q4) The actions of IL-1 and IL-10 are an example of:
A) redundancy
B) antagonism
C) synergy
D) pleiotropy
Page 7
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Chapter 6: Complement System
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Sample Questions
Q1) Which complement protein is the key intermediate in all pathways?
A) C4
B) C2
C) C3
D) C1
Q2) Binding of a lectin to a sugar found in bacteria and fungi occurs in which complement pathway?
A) alternative pathway
B) classical pathway
C) MBL pathway
D) all of the above
Q3) What is cleaved by C4b2a3b?
A) C3
B) C4
C) C5
D) C6
Q4) What is cleaved by C3bBb?
A) C3
B) C5
C) C6
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Chapter 7: Safety and Specimen Preparation
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Sample Questions
Q1) Information on any potentially toxic substance used in a laboratory test kit would be found in:
A) OSHA's Occupational Exposure to Bloodborne Pathogens Standard
B) chemical hygiene plan
C) material safety data sheet
D) exposure control plan
Q2) Which series of dilutions would be best in order to make a 1:3000 dilution?
A) 1:10,1:3,1:10
B) 1:5,1:6,1:100
C) 1:3,1:100,1:100
D) 1:30,1:10,1:100
Q3) If 0.9 mL of saline is added to 0.1 mL of serum,what does the 0.9 mL represent?
A) the final dilution
B) the diluent
C) the solute
D) the total solution
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9
Chapter 8: Precipitation Reactions
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Sample Questions
Q1) The radial immunodiffusion test is a method involving:
A) agglutination
B) flocculation
C) precipitation
D) neutralization
Q2) The Western blot test used to confirm HIV is an example of which of the following?
A) immunofixation
B) immunoelectrophoresis
C) double diffusion
D) passive agglutination
Q3) In an Ouchterlony immunodiffusion procedure,a continuous arc of precipitate is observed between two adjacent wells.This is a reaction of:
A) identity
B) non-identity
C) partial identity
Q4) A situation in which antigen is in excess as compared to antibody is called:
A) prozone
B) postzone
C) equivalence zone
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Chapter 9: Agglutination
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Sample Questions
Q1) When carrier particles are coated with an antigen that is not normally found on them,this is known as:
A) direct agglutination
B) passive agglutination
C) reverse passive agglutination
D) hemagglutination
Q2) If a Coombs' test is positive,which of the following is true?
A) Antibody has coated patient red blood cells in vitro.
B) Antigen is reacting with patient antibody.
C) Antibody has coated patient red blood cells in vivo.
D) Antigen has coated patient red blood cells in vivo.
Q3) What would be the best test to determine evidence of hemolytic disease of the newborn?
A) direct antiglobulin testing
B) passive agglutination
C) coagglutination testing
D) indirect antiglobulin testing
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11
Chapter 10: Labeled Immunoassays
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Sample Questions
Q1) In a sandwich or capture assay to determine the presence of a viral antigen in a patient sample,which of the following would be on solid phase?
A) antigen
B) labeled antibody
C) unlabeled antibody
D) antihuman immunoglobulin
Q2) Which of the following is characteristic of noncompetitive enzyme immunoassays?
A) Binding sites for patient antigen are limited.
B) Washing in between steps is not necessary.
C) All patient antigen is allowed to react with binding sites.
D) Color is indirectly proportional to the concentration.
Q3) Which of the following best describes homogeneous assays?
A) A washing step is necessary.
B) Concentration of patient antigen is directly proportional to the label detected.
C) The reagent antibody has an enzyme tag.
D) Labeled and unlabeled analyte are present in equal amounts.
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12
Chapter 11: Molecular Techniques
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Sample Questions
Q1) Which is the correct conclusion if results of DNA restriction analysis by gel electrophoresis show a difference in one band?
A) The samples are the same.
B) The samples are not identical.
C) Gel electrophoresis should be repeated.
D) The wrong buffer was used in electrophoresis.
Q2) In which technique is the signal amplified instead of the actual target DNA?
A) branched DNA amplification
B) PCR
C) transcription-mediated amplification
D) solution hybridization
Q3) A reaction characterized by amplification of a specific region of a DNA strand through denaturing and annealing best describes which of the following?
A) signal amplification
B) polymerase chain reaction
C) solution hybridization
D) ligase chain reaction
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13
Chapter 12: Flow Cytometry and Laboratory Automation
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Sample Questions
Q1) As measured in flow cytometry,cells that are the smallest and have the least granules would be identified as:
A) lymphocytes
B) granulocytes
C) monocytes
D) erythrocytes
Q2) The expression of cell surface markers is determined in the flow cytometer by which of the following?
A) chemiluminescence
B) fluorescence
C) optical density
D) radioactivity
E) scatter
Q3) A range of values that all produce a positive result is known as:
A) analytic sensitivity
B) reportable range
C) accuracy
D) precision
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14
Chapter 13: Hypersensitivity
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Sample Questions
Q1) All of the following hypersensitivity reactions involve activation of complement EXCEPT:
A) allergic reactions
B) hemolytic disease of the newborn
C) autoimmune hemolytic anemia
D) serum sickness
Q2) Preformed mediators that are released during the activation phase of a type I hypersensitivity include which of the following?
A) histamine
B) cyclooxygenase
C) leukotriene
D) prostaglandin
Q3) Anaphylaxis is characterized by which of the following?
A) degranulation of mast cells
B) production of IgG
C) T-cell mediators
D) all of the above
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Page 15
Chapter 14: Autoimmunity
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Sample Questions
Q1) 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
Q2) 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
Q3) The "CREST" variant of which disease is associated with the presence of an anticentromere antibody?
A) progressive systemic sclerosis (scleroderma)
B) rheumatoid arthritis
C) systemic lupus erythematosus
D) mixed connective tissue disease
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16
Chapter 15: Immunoproliferative Diseases
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Sample Questions
Q1) What is the main difference between leukemias and lymphomas?
A) In leukemias,malignant cells are mainly located in the tissues.
B) Lymphomas are present mainly in peripheral blood.
C) Lymphomas arise due to a lack of response to stimulating antigens.
D) Lymphomas arise mainly in lymph nodes,the spleen,or other lymphoid tissue.
Q2) Which best describes the difference between chronic and acute lymphocytic leukemias?
A) Chronic lymphocytic leukemias are exclusive of T-cell origin.
B) Acute lymphocytic leukemias have a high response rate to chemotherapy.
C) Chronic lymphocytic leukemias have a shorter survival time.
D) Acute lymphocytic leukemias progress more slowly.
Q3) A 55-year-old male presents with symptoms that include weakness,loss of appetite,and anemia.Immunofixation electrophoresis reveals a heavy IgM band.Which of the following is the most likely diagnosis?
A) SCID
B) multiple myeloma
C) Waldenström's macroglobulinemia
D) DiGeorge syndrome
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17
Chapter 16: Immunodeficiency Disease
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Sample Questions
Q1) 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 low-set ears.Lab testing reveals an absence of T cells.What is the most likely diagnosis?
A) selective IgA deficiency
B) common variable immunodeficiency
C) Waldenström's macroglobulinemia
D) DiGeorge syndrome
Q2) Which of the following diseases results in an acquired or secondary immunodeficiency?
A) HIV infection
B) Bruton's agammaglobulinemia
C) leukocyte adhesion deficiency
D) Wiskott-Aldrich syndrome
Q3) Which of the following best describes common variable immunodeficiency disease?
A) Symptoms appear in infancy.
B) It is inherited as an X-linked recessive.
C) It is invariably fatal for the patient.
D) There is a deficiency of IgA and/or IgG.
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Page 18
Chapter 17: Transplantation Immunology
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Sample Questions
Q1) Transplantation of an individual's skin from one place to another is an example of a(n):
A) autograft
B) allograft
C) xenograft
D) heterograft
Q2) 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?
A) HLA A1,B11
B) HLA B2 only
C) HLA A1,A3,B11
D) cannot be determined from these results
Q3) Graft-versus-host disease results under which conditions?
A) when immunocompetent cells are placed in an immunocompromised host
B) when immunodeficient cells are placed in an immunocompetent host
C) any time tissue is not exactly matched in a transplant
D) only when adult cells are transplanted into a baby
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Page 19
Chapter 19: Tumor Immunology
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Sample Questions
Q1) 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?
A) The titer is 1:640,and the patient may have glomerulonephritis.
B) The titer is 1:160,and the patient may have rheumatic fever.
C) The titer is 1:80,and the patient is normal.
D) The test is invalid and must be repeated.
Q2) Organisms that are short rods or coccobacilli and obligate intracellular bacteria best describes:
A) Streptococcus pyogenes
B) Helicobacter pylori
C) Rickettsia prowazekii
D) Mycoplasma pneumonia
Q3) Which of the following statements best describes Helicobacter pylori?
A) It is a gram-positive coccus that causes skin infections.
B) It is a gram-negative spiral that causes ulcers.
C) It lacks a cell wall and produces a lot of acid.
D) It can be detected by testing for cold agglutinins.
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Page 20
Chapter 20: Serologic and Molecular Detection of Bacterial
Infections
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Sample Questions
Q1) A 30-year-old male patient with AIDS exhibits pulmonary symptoms that include coughing and some difficulty breathing.The patient reported that he had previously worked in a bakery.His white blood cell count was normal,indicating that the infection is not bacterial in nature.Tests for the presence of fungal antigens were performed with the following results: ouchterlony immunodiffusion negative for antibodies to Aspergillus; negative latex agglutination test for Candida antigen,and positive EIA test for the galactomannan antigen of Aspergillus.What conclusion can be reached from these results?
A) The galactomannan is a false-positive result.
B) The infection is likely caused by Aspergillus.
C) The Candida antigen test is a false-negative
D) An Aspergillus infection is ruled out due to negative antibody testing.
Q2) Why is testing for Cryptococcal antigen preferred over testing for antibodies?
A) This is usually not a humoral response to infection.
B) Immunocompromised patients do not produce antibody.
C) Subclinical infection can be detected.
D) all of the above
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Page 21
Chapter 21: Serologic and Molecular Detection of Bacterial
Infections
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Sample Questions
Q1) Which of the following may characterize the disease process in syphilis?
A) generalized rash
B) period of latency
C) localized chancre
D) all of the above
E) all except one of the above
Q2) Which of the following is a cause of a laboratory-induced false-negative in the screening tests for syphilis?
A) alcohol ingestion prior to blood draw
B) systemic lupus erythematosus
C) excess serum
D) hot laboratory
Q3) A 30-year-old man presents to the physician with a painless ulcer on his penis.An RPR performed on the man is reactive 1:128,and the MHA-TP test is positive.This man has:
A) Neisseria gonorrhoeae
B) Chlamydia trachomatis
C) Treponema pallidum
D) Mycoplasma hominis
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Chapter 22: Serology of Parasitic and Fungal Infections
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Sample Questions
Q1) A patient has detectable levels of IgG and IgM against the viral capsid antigens of Epstein-Barr virus (EBV).This patient has:
A) been infected with EBV in the past
B) an infection with HIV,too
C) a current infection with EBV
D) never had EBV
Q2) Serology is performed on a patient with a rash and fever with the following results:
rubella IgM = positive; rubella IgG = positive; measles IgM = negative; measles IgG = positive; varicella-zoster IgM = negative; varicella-zoster IgG = negative.What is the interpretation of these results?
A) acute infection with rubella virus
B) acute infection with measles virus
C) not immune to measles or rubella viruses
D) immune to varicella-zoster virus only
Q3) All of the following are characteristic of the Epstein Barr virus EXCEPT:
A) latent virus
B) DNA virus
C) cause of infectious mono
D) invades T cells
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Page 23
Chapter 23: Spirochete Diseases
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Sample Questions
Q1) A patient has serum tested for HIV antibodies by ELISA,and the test is positive.The patient's serum is retested in duplicate with two more positive results.What should be done next?
A) Patient is diagnosed with acute HIV infection.
B) Serum is tested for antibodies against hepatitis C virus.
C) HIV Western blot assay is performed on patient's serum.
D) Results mean that patient had HIV in the past but not now.
Q2) All of the following body fluids are considered to be possible routes of transmission for HIV even if there is no visible sign of blood EXCEPT:
A) spinal fluid
B) semen
C) urine
D) vaginal secretions
Q3) Viral load testing is of most clinical utility in all of the following situations EXCEPT:
A) initial diagnosis of HIV infection when antibody tests are positive
B) monitoring patients during antiretroviral therapy
C) setting a baseline before antiretroviral therapy has begun
D) investigating a patient's sudden drop in T-cell count
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