Diagnostics in Immunology Question Bank
Course Introduction
Diagnostics in Immunology explores the fundamental principles and advanced methodologies used to detect, monitor, and interpret immune responses in clinical and research settings. The course covers a wide array of diagnostic techniques, including serological assays, flow cytometry, immunohistochemistry, molecular diagnostics, and next-generation sequencing, with an emphasis on their application in the diagnosis of infectious diseases, autoimmune disorders, immunodeficiencies, allergies, and cancers. Students will gain a comprehensive understanding of assay selection, interpretation of results, quality control, and emerging technologies, preparing them to apply immunological diagnostics effectively in laboratory and clinical environments.
Recommended Textbook
Clinical Immunology and Serology A Laboratory Perspective 4th Edition by Christine Dorresteyn
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25 Chapters
784 Verified Questions
784 Flashcards
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Page 2
Chapter 1: Introduction to Immunity and the Immune System
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Sample Questions
Q1) Which of the following is characteristic of mucosal-associated lymphoid tissue?
A) It is one of the primary lymphoid organs.
B) It clears pathogens from the bloodstream.
C) It includes the tonsils and the appendix.
D) It includes the liver and spleen.
Answer: C
Q2) Which of the following is a characteristic of natural killer cells?
A) They mature in the thymus.
B) They are smaller than B and T cells.
C) They are a type of lymphocyte.
D) They are part of the adaptive immune system.
Answer: C
Q3) Antibodies are secreted by:
A) plasma cells.
B) B cells.
C) T cells.
D) dendritic cells.
Answer: A
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Chapter 2: Nature of Antigens and the Major
Histocompatibility Complex
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Sample Questions
Q1) Naturally occurring anti-A and anti-B antibodies are thought to be the result of exposure to which of the following?
A) Heterophile antigens
B) Haptens
C) Alloantigens
D) Autoantigens
Answer: A
Q2) Which of the following must be matched between donor and recipient as closely as possible to avoid rejection of a tissue transplant?
A) Haptens
B) MHC molecules
C) Transporters associated with antigen processing
D) Beta-2 microglobulins
Answer: B
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4
Chapter 3: Innate Immunity
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Sample Questions
Q1) All of the following are characteristic of acute-phase reactants EXCEPT:
A) they are constituents that increase rapidly in response to infection.
B) they are used to diagnose a specific disease.
C) they enhance phagocytosis.
D) they limit destruction of host tissue.
Answer: B
Q2) Which acute-phase reactant is an important clotting factor?
A) Haptoglobin
B) Ceruloplasmin
C) Fibrinogen
D) Alpha-2 macroglobulin
Answer: C
Q3) Macrophages use all of the following to kill bacteria EXCEPT:
A) hydrogen peroxide.
B) perforin.
C) hydroxyl radical.
D) lysozyme.
Answer: B
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5
Chapter 4: Adaptive Immunity
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Sample Questions
Q1) A critical receptor involved in the second signal for T-dependent B-cell activation is:
A) CD3.
B) CD19.
C) CD40.
D) surface IgM.
Q2) A T-independent antibody response:
A) involves memory cells.
B) results in the secretion of primarily IgM.
C) is usually triggered by haptens.
D) requires antigen binding to surface IgD.
Q3) The only cells in the body capable of specifically recognizing and distinguishing different antigenic determinants are:
A) macrophages.
B) dendritic cells.
C) lymphocytes.
D) neutrophils.
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Chapter 5: Antibody Structure and Function
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Sample Questions
Q1) Which of the following is a characteristic of IgA?
A) It is found in secretions.
B) It fixes complement.
C) It is a pentamer in serum.
D) It is the primary response antibody.
Q2) The antibody that appears first in an immune response and is a pentamer with a molecular weight of 900,000 Da best describes:
A) IgM.
B) IgD.
C) IgA.
D) IgG.
Q3) Which immunoglobulin activates the classical complement pathway?
A) IgD
B) IgM
C) IgA
D) IgE
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Chapter 6: Cytokines
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Sample Questions
Q1) The main target of IL-3 is:
A) antigen-activated B cells.
B) antigen-activated T cells.
C) macrophages.
D) stem cells.
Q2) When IL-2 acts on T cells,B cells,and natural killer cells,this is an example of:
A) redundancy.
B) pleiotropy.
C) synergy.
D) antagonism.
Q3) What is a main function of chemokines?
A) Inhibit the immune response
B) Enhance synthesis of acute-phase reactants
C) Establish a concentration gradient to guide cell movement
D) Protect cells from viral invasion
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8
Chapter 7: Complement System
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Sample Questions
Q1) Kidney glomeruli can become obstructed with immune complexes as a result of:
A) properdin deficiency.
B) inadequate C3b-mediated opsonization.
C) membrane attack complex formation.
D) autoantibodies that bind C3bBb.
Q2) A patient has an abnormal alternative pathway activation pattern.Which of the following complement proteins should be assessed to further investigate the problem?
A) C1
B) C2
C) C3
D) C4
Q3) Dense deposits of C3 breakdown products can accumulate in the kidneys because of:
A) properdin deficiency.
B) inadequate C3b-mediated opsonization.
C) membrane attack complex formation.
D) autoantibodies that bind C3bBb.
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Chapter 8: Safety and Quality Management
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Sample Questions
Q1) According to Clinical Laboratory Improvement Amendments (CLIA)regulations,which of the following applies to a test that is easy to perform and interpret?
A) It is considered a moderately complex test.
B) It can be performed by someone who does not have specific training.
C) It is considered a nonwaived test.
D) It can only be performed in a reference laboratory.
Q2) What does the acronym PASS stand for?
A) Pull, aim, squeeze, sweep
B) Pass, activate, sweep, scram
C) Pull, alarm, squeeze, sweep
D) Pass, activate, scram, scream
Q3) A blood spill occurs in the immunology laboratory.What should you do?
A) Call housekeeping to wash the area.
B) Make a 1:10 solution of bleach and wash the area.
C) Wipe up the spill with paper towels.
D) Wipe the area with concentrated bleach.
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Chapter 9: Principles of Serological Testing
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Sample Questions
Q1) A blood sample is processed,and the resulting serum is pink.This indicates:
A) a normal serum sample.
B) a hemolyzed serum sample, but hemolysis is common and can be ignored.
C) a hemolyzed serum sample, which may adversely affect testing.
D) definite evidence of bacterial contamination.
Q2) If the assay was used to test a different population consisting of 240 infected patients and 50 healthy controls,which assay parameter would increase?
A)Sensitivity
B)Specificity
C)Positive predictive value
D)Negative predictive value
Q3) Calculate the assay's specificity.
A)57%
B)75%
C)80%
D)90%
Q4) An antibody titer is defined as the reciprocal of the:
A) last serial dilution tube in which a positive reaction is still visible.
B) first serial dilution tube in which a negative reaction is achieved.
C) diluent divided by the solvent.
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Chapter 10: Precipitation and Agglutination Reactions
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Sample Questions
Q1) In immunofixation electrophoresis,antibody is:
A) distributed uniformly throughout the gel.
B) applied on the top surface of the gel.
C) added to troughs cut into the gel.
D) driven through the gel by application of electrical current.
Q2) Agglutination reactions run at room temperature are appropriate for antigen-antibody reactions involving:
A) IgA.
B) IgE.
C) IgG.
D) IgM.
Q3) The assembly of particles into visible clumps is called:
A) precipitation.
B) agglutination.
C) equivalence.
D) sensitization.
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Chapter 11: Labeled Immunoassays
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Sample Questions
Q1) Identify the characteristic associated with noncompetitive enzyme immunoassays.
A) They are less sensitive than agglutination reactions.
B) They are used when quantitation is necessary.
C) Antibody is bound to the solid phase.
D) Binding sites for patient antibody are limited.
Q2) An immunoassay is performed in the following way: Antigen is bound to a solid support.Patient serum is added,and patient antibodies bind to the antigen.The well is washed,and enzyme-labeled anti-immunoglobulin antibodies are added.The well is washed,and enzyme substrate is added.Enzyme activity is determined.Which immunoassay is described?
A) Capture
B) Competitive
C) ELISA
D) Homogeneous
Q3) The standard method for detecting antinuclear antibodies (in certain autoimmune diseases)is:
A) direct immunofluorescence.
B) indirect immunofluorescence.
C) fluorescence polarization.
D) autofluorescence.
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Chapter 12: Molecular Diagnostic Techniques
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Sample Questions
Q1) Light is generated when nucleotides are added to a growing strand of DNA in the process of:
A) pyrosequencing.
B) ligase chain reaction.
C) strand displacement amplification.
D) branched DNA amplification.
Q2) A short strand of DNA or RNA used to detect an unknown nucleic acid in a patient specimen best describes a:
A) nucleic acid probe.
B) restriction enzyme.
C) primer.
D) restriction fragment length polymorphism.
Q3) Select the strand of RNA that is complementary to this single strand of DNA: A T T A G C C G T A T
A) T A A T C G G C A T A
B) U A A U C G G C U A U
C) T U U T C G G C A U A
D) T A A T U G G U A T A
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14
Chapter 13: Flow Cytometry and Laboratory Automation
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Sample Questions
Q1) What is meant by "gating" in flow cytometry?
A) The chromatic arrangement of cellular populations
B) The process by which one cell population adheres to another population
C) An electronic window separating subpopulations of cells
D) An electronic device measuring all populations of cells
Q2) What is a disadvantage of automated testing in a clinical immunology laboratory?
A) Decreases potential for manual errors
B) Increases dependence on a single machine
C) Cannot be used within the preanalytical stage of testing
D) Cannot perform combined chemistry and immunoassay testing on a single platform
Q3) Which description best describes the reportable range?
A) Span of test result values over which the laboratory can establish or verify the accuracy of an instrument or test system
B) Range of test values found in a healthy population of people
C) Variation observed in repeated measurements of the same sample
D) Difference in concentration between the highest and lowest standards used in the standard curve
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15
Chapter 14: Hypersensitivity
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Sample Questions
Q1) A direct antiglobulin test is ordered on a patient sample.This test detects:
A) in vivo attachment of antibodies to red blood cells.
B) allergic reaction.
C) passive agglutination.
D) naturally occurring antibodies.
Q2) To determine if a patient is allergic to peanuts,the best test to perform is:
A) allergen-specific IgE.
B) total serum IgE.
C) serum protein electrophoresis.
D) RID to measure IgG.
Q3) An exaggerated reaction directed against an antigen that is harmless is called:
A) atopy.
B) hypersensitivity.
C) immune complex disease.
D) passive cutaneous anaphylaxis.
Q4) 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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Chapter 15: Autoimmunity
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Sample Questions
Q1) A 30-year-old clinical laboratory science student complains of being tired but is not able to sleep.The woman also states that her hair has been breaking off,and she has lost 20 pounds over the past 2 months without trying.The woman's pulse and blood pressure are elevated,and her eyes seem to be bulging.Her complete blood count (CBC)is normal,thyroid-stimulating hormone is decreased,and T4 is increased.Antimicrosomal and antithyroglobulin antibodies are each 1:400.This woman most likely has:
A) Addison's disease.
B) Graves disease.
C) Hashimoto's thyroiditis.
D) type 1 diabetes.
Q2) Antibodies directed against thyroglobulin represent a significant finding in which of the following autoimmune diseases?
A) Myasthenia gravis
B) Multiple sclerosis
C) Hashimoto's thyroiditis
D) Contact dermatitis
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Chapter 16: Transplantation Immunology
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Sample Questions
Q1) In direct allorecognition,the recipient T cells bind and respond directly to foreign HLA proteins.
A)True
B)False
Q2) The type of allograft rejection associated with fibrosis and scarring of vessel lumens is:
A) a hyperacute rejection.
B) an acute antibody-mediated rejection.
C) an acute cellular rejection.
D) a chronic rejection.
Q3) A transplant patient has been prescribed corticosteroids as part of his post-transplant medication regimen.What class of drug is the patient taking?
A) Hormone
B) Immunosuppressive
C) Anti-metabolite
D) Calcineurin inhibitor
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Chapter 17: Tumor Immunology
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Sample Questions
Q1) Alpha-fetoprotein
A)Hepatocellular carcinoma
B)Ovarian cancer
C)Colorectal, breast, or lung cancer
D)Breast cancer only
E)Pancreatic and gastrointestinal cancers
Q2) In which of the following conditions would you not see an increase in alpha-fetoprotein?
A) Pregnancy
B) Hepatocellular carcinoma
C) Hepatitis
D) Hypercholesteremia
Q3) A tumor that is classified as malignant is described as:
A) a disorganized mass that is not encapsulated and can invade nearby organs.
B) a slow-growing, organized mass of encapsulated cells.
C) usually confined to the skin.
D) an area of swelling that shows no abnormal growth of cells.
Q4) Tumor-associated antigens are expressed only in tumor cells.
A)True
B)False
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Chapter 18: Immunoproliferative Diseases
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Sample Questions
Q1) What is the correct order of protein migration,starting at the cathode and moving to anode,following serum protein electrophoresis?
A) Albumin, gamma, alpha 1, alpha 2, beta
B) Albumin, alpha 1, alpha 2, beta, and gamma
C) Gamma, beta, alpha 2, alpha 1, albumin
D) Beta, gamma, alpha 2, and alpha 1, albumin
Q2) Which marker is highly specific for hairy-cell leukemia?
A) CD19
B) CD20
C) CD25
D) CD103
Q3) Which type of gene is required for cell growth and division but can cause malignant transformation when altered?
A) Tumor suppressor gene
B) Proto-oncogene
C) Anti-tumor gene
D) Immunoglobulin gene
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Chapter 19: Immunodeficiency Diseases
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Sample Questions
Q1) Which of the following statements best describes common variable immunodeficiency?
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, IgG, or both.
Q2) Patients with recombinase activating gene 1 (RAG-1)or RAG-2 deficiencies have decreased numbers of:
A) monocytes.
B) granulocytes.
C) lymphocytes.
D)all of the above.
Q3) The most common form of severe combined immunodeficiency disease results from an X-linked mutation in the gene that codes for:
A) interleukin-2.
B) a receptor subunit involved in signaling for interleukins-2, -4, -7, and -9.
C) a common subunit involved in signaling for the B-cell receptor and T-cell receptor complexes.
D) a sequence common to CD3 and CD19.
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Page 21
Chapter 20: Serological and Molecular Detection of Bacterial Infections
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Sample Questions
Q1) Which of the following illnesses is not caused by Streptococcus pyogenes directly,but rather by destructive host defense responses?
A) Pharyngitis
B) Pyoderma (impetigo)
C) Acute rheumatic fever
D) Scarlet fever
Q2) Antibodies detected by reacting patient serum with rickettsial antigens,followed by incubation with an anti-immunoglobulin with a fluorescent tag,could be used to diagnose:
A) Rocky Mountain spotted fever.
B) Mycoplasma pneumonia.
C) stomach ulcers.
D) rheumatic fever.
Q3) The cold agglutinins that develop in patients infected with Mycoplasma pneumoniae are:
A) IgG specific for M pneumoniae.
B) IgG specific for M pneumoniae exotoxin.
C) IgM that reacts with I antigen on red blood cells.
D) IgM that reacts with ASO antigens on M pneumoniae.
Page 22
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Chapter 21: Spirochete Diseases
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Sample Questions
Q1) Tests for specific treponemal antibody include which of the following?
A) VDRL
B) RPR
C) FTA-ABS
D) All of the above
Q2) A 30-year-old man presents to his physician with a painless ulcer on his penis.An RPR performed on the man is reactive 1:128,and the TP-PA test is positive.This man has an infection with:
A) Neisseria gonorrhoeae.
B) Chlamydia trachomatis.
C) Treponema pallidum.
D) Mycoplasma hominis.
Q3) The vectors that transmit Borrelia burgdorferi from natural reservoirs to humans are:
A) deer.
B) mice.
C) ticks.
D) birds.
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Chapter 22: Serological and Molecular Diagnosis of Parasitic
and Fungal
Infections
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Q1) Suppose a parasite invades a patient and causes disease.The patient develops immunity and is ultimately cured.This outcome is considered what type of host-parasite interaction?
A) Symbiosis
B) Commensalism
C) Sterilizing immunity
D) Concomitant immunity
Q2) An example of a fungal organism that commonly causes systemic infections is:
A) Malassezia furfur.
B) Trichophyton species.
C) Cryptococcus neoformans.
D) Candida albicans.
Q3) A patient has been diagnosed with tapeworm.Identify the type of parasitic organism involved.
A) Protozoa
B) Helminth
C) Ectoparasite
D) Host
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Chapter 23: Serology and Molecular Detection of Viral Infections
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Sample Questions
Q1) A patient has the following Epstein-Barr virus (EBV)antibody profile: EB-VCA IgM = neg; EB-VCA IgG = pos; EBV-EA-R IgG = pos; EBV-EBNA IgG = pos.Which of the following is the correct interpretation of these data?
A) Never infected with EBV
B) Acute infection with EBV
C) Recent convalescence from EBV
D) Reactivation of past infection with EBV
Q2) Interferons alpha and beta help the host in defense against viral infections by:
A) enhancing antibody production.
B) stimulating cytotoxic T cells.
C) activating Toll-like receptors.
D) inhibiting viral replication.
Q3) Viruses can evade host defenses by:
A) maintaining a stable genetic identity.
B) inducing increased expression of MHC class I.
C) inducing increased expression of MHC class II.
D) hiding from the immune system in a latent state.
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Chapter 24: Laboratory Diagnosis of HIV Infection
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Q1) Histoplasmosis (disseminated or extrapulmonary)is an opportunistic infection of stage 3 HIV infection.
A)True
B)False
Q2) Which of the following peripheral blood measurements is used to determine the stage of HIV infection?
A) The number of CD4 T cells
B) The number of CD8 T cells
C) The number of HIV RNA copies
D) The HIV antibody titer
Q3) p24
A) Component of reverse transcriptase enzyme
B) Transmembrane protein
C) Envelope protein that binds to CD4 on T cells
D) Core coat for nucleic acids
Q4) Of the designated subtypes of HIV,which is the most common in the United States?
A) Subtype B
B) Subtype C
C) Subtype A
D) Subtype K
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Chapter 25: Immunization and Vaccines
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Sample Questions
Q1) Trastuzumab,an antibody used in the treatment of breast cancer with an overexpression of the HER2 marker,is an example of a
A) mouse monoclonal antibody.
B) chimeric antibody.
C) humanized antibody.
D) fully human antibody.
Q2) An inactivated vaccine is used clinically to prevent:
A) chickenpox.
B) measles.
C) mumps.
D) influenza.
Q3) A mother provides immunity to her unborn child in the womb via which process?
A) Active immunity
B) Passive immunity
C) Adoptive immunity
D) Adoptive immunotherapy
Q4) Hematopoietic stem cell transplantation is an example of adoptive immunity.
A)True
B)False
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