Saint Louis University

SCHOOL OF NURSING, ALLIED HEALTH, AND BIOLOGICAL SCIENCES

Department of Medical Laboratory Science

MLS 412 MEDICAL TECHNOLOGY ASSESSMENT PROGRAM (MTAP) 2

PRE-ASSESSMENT: IMMUNOLOGY AND SEROLOGY
MULTIPLE CHOICE. Choose the BEST answer.

1. Which of the following is NOT a function of the immune system?

a) Protecting against pathogens
b) Removing dead or damaged cells
c) Repairing broken bones
d) Recognizing and destroying abnormal cells
2. The first line of defense against infection includes all of the following EXCEPT:
a) Skin
b) Mucous membranes
c) Antibodies
d) Stomach acid
3. Innate immunity is characterized by:
a) Specific response to a particular antigen
b) Rapid response and lack of memory
c) Slow response and long-lasting memory
d) Involvement of lymphocytes
4. Which of the following is a phagocytic cell?
a) T lymphocyte
b) B lymphocyte
c) Neutrophil
d) Plasma cell
5. Inflammation is characterized by all of the following signs EXCEPT:
a) Redness
b) Swelling
c) Pain
d) Vasoconstriction
6. What is the role of complement in the immune system?
a) Directly killing pathogens
b) Opsonization and lysis of pathogens
c) Activating T lymphocytes
d) Producing antibodies
7. Which of the following is a primary lymphoid organ?
a) Spleen
b) Lymph node
c) Thymus
d) Tonsils
8. Where do T lymphocytes mature?
a) Bone marrow
b) Spleen
c) Thymus
d) Lymph nodes
9. What is an antigen?
a) A cell that produces antibodies
b) A molecule that triggers an immune response
c) A protein that destroys pathogens
d) A type of white blood cell
10. Adaptive immunity is characterized by:
a) Rapid response and lack of memory
b) Slow response and long-lasting memory
c) Non-specific response to pathogens
d) Involvement of physical barriers
11. Which type of lymphocyte is responsible for cell-mediated immunity?
a) B lymphocyte
b) T lymphocyte
c) Plasma cell
d) Natural killer cell
12. Antibodies are produced by:
a) T lymphocytes
b) Macrophages
c) Plasma cells
d) Neutrophils
13. What is the function of antibodies?
a) To directly kill infected cells
b) To recognize and bind to antigens
c) To stimulate inflammation
d) To phagocytose pathogens
14. Which antibody isotype is the most abundant in serum?
a) IgM
b) IgA
c) IgG
d) IgE
15. Which antibody isotype is involved in allergic reactions?
a) IgM
b) IgA
c) IgG
d) IgE
16. What is an epitope?
a) The part of an antibody that binds to an antigen
b) The part of an antigen that is recognized by an antibody
c) A type of immune cell
d) A signaling molecule
17. MHC class I molecules present antigens to:
a) Helper T cells
b) Cytotoxic T cells
c) B cells
d) Macrophages
18. MHC class II molecules present antigens to:
a) Helper T cells
b) Cytotoxic T cells
c) B cells
d) Natural Killer cells
19. What is the role of helper T cells?
a) To directly kill infected cells
b) To activate B cells and cytotoxic T cells
c) To produce antibodies
d) To phagocytose pathogens
20. Cytotoxic T cells kill infected cells by:
a) Phagocytosis
b) Releasing cytotoxic granules
c) Producing antibodies
d) Stimulating inflammation
21. What is immunological memory?
a) The ability of the immune system to forget previous infections
b) The ability of the immune system to mount a faster and stronger response to subsequent encounters with the same antigen
c) The ability of the immune system to only respond to new antigens
d) The lack of response to self-antigens
22. Active immunity is acquired through:
a) Receiving antibodies from another source
b) Exposure to an antigen and production of antibodies
c) Inheriting immune cells from parents
d) Physical barriers
23. Passive immunity is acquired through:
a) Exposure to an antigen and production of antibodies
b) Receiving antibodies from another source
c) Inheriting immune cells from parents
d) Physical barriers
24. Vaccination provides what type of immunity?
a) Natural passive immunity
b) Artificial passive immunity
c) Natural active immunity
d) Artificial active immunity
25. What is an adjuvant?
a) An antigen used in vaccines
b) A substance that enhances the immune response to an antigen
c) An antibody that neutralizes toxins
d) A type of immune cell
26. A hypersensitivity reaction is:
a) A normal and protective immune response
b) An exaggerated or inappropriate immune response
c) A lack of immune response
d) A type of autoimmune disease
27. Anaphylaxis is an example of what type of hypersensitivity reaction?
a) Type I
b) Type II
c) Type III
d) Type IV
28. Autoimmune diseases occur when:
a) The immune system fails to recognize foreign antigens
b) The immune system attacks the body's own tissues
c) The immune system is suppressed
d) The immune system produces too many antibodies
29. Rheumatoid arthritis is an example of:
a) Immunodeficiency
b) Autoimmune disease
c) Hypersensitivity
d) Infection
30. Immunodeficiency is characterized by:
a) An overactive immune system
b) A weakened or absent immune system
c) An allergic reaction
d) An autoimmune response
31. HIV causes which type of immunodeficiency?
a) Primary immunodeficiency
b) Secondary immunodeficiency
c) Autoimmune disease
d) Hypersensitivity
32. Serology is the study of:
a) Blood cells
b) Antigens and antibodies in serum
c) The complement system
d) Cell-mediated immunity
33. A positive serological test indicates:
a) The absence of a particular antigen or antibody
b) The presence of a particular antigen or antibody
c) A normal immune response
d) An autoimmune reaction
34. Agglutination is:
a) The clumping of cells or particles
b) The lysis of cells
c) The precipitation of soluble antigens
d) The neutralization of toxins
35. Precipitation is:
a) The clumping of cells or particles
b) The lysis of cells
c) The formation of a visible complex between a soluble antigen and antibody
d) The neutralization of toxins
36. In an ELISA (Enzyme-Linked Immunosorbent Assay), what is detected?
a) Antigens only
b) Antibodies only
c) Antigen-antibody complexes
d) Complement proteins
37. Western blotting is used to:
a) Detect specific DNA sequences
b) Detect specific RNA sequences
c) Detect specific proteins
d) Detect specific cell types
38. Flow cytometry is used to:
a) Separate DNA fragments
b) Identify and count cells based on their surface markers
c) Amplify DNA sequences
d) Visualize cells under a microscope
39. A titer is a measure of:
a) The concentration of antigen
b) The concentration of antibody
c) The number of immune cells
d) The size of an antigen-antibody complex
40. A rising antibody titer indicates:
a) A recent infection
b) A past infection
c) Immunodeficiency
d) Autoimmunity
41. The purpose of a control in a serological test is to:
a) Increase the sensitivity of the test
b) Increase the specificity of the test
c) Ensure the test is working correctly
d) Identify the antigen
42. What does "specificity" refer to in the context of an antibody?
a) Its ability to bind to many different antigens
b) Its ability to bind to a specific epitope on an antigen
c) Its concentration in the serum
d) Its isotype (e.g., IgG, IgM)
43. What is the primary function of a B cell?
a) Directly killing infected cells.
b) Phagocytosing pathogens.
c) Producing antibodies.
d) Activating T cells.
44. Which of the following is an example of artificially acquired passive immunity?
a) Transfer of antibodies from mother to fetus through the placenta.
b) Getting sick with the measles.
c) Receiving an injection of antibodies (e.g., anti-venom).
d) Breastfeeding a baby.
45. What is meant by the term "opsonization?"
a) The process of directly killing a pathogen.
b) The process of coating a pathogen to enhance phagocytosis.
c) The process of neutralizing a toxin.
d) The process of activating complement.
46. Which type of hypersensitivity reaction involves the formation of immune complexes that deposit in tissues?
a) Type I
b) Type II
c) Type III
d) Type IV
47. Contact dermatitis, such as poison ivy, is an example of:
a) Type I hypersensitivity
b) Type II hypersensitivity
c) Type III hypersensitivity
d) Type IV hypersensitivity
48. In the context of immunology, what does "tolerance" refer to?
a) The ability of the immune system to mount a strong response to any antigen.
b) The ability of the immune system to not respond to self-antigens.
c) The ability of the immune system to only respond to foreign antigens.
d) The process of antibody production.
49. What cell type is primarily targeted and destroyed by HIV?
a) B cells
b) Cytotoxic T cells
c) Helper T cells
d) Macrophages
50. The primary immunological barrier to successful organ transplantation is:
a) Antibody-mediated cytotoxicity
b) T cell-mediated rejection
c) Complement activation
d) Natural killer cell activity
51. HLA (Human Leukocyte Antigen) matching is critical in transplantation because these molecules:
a) Are only present on red blood cells.
b) Present antigen to T cells and trigger an immune response if mismatched.
c) Directly kill transplanted cells.
d) Activate complement.
52. Which type of T cell is primarily responsible for acute graft rejection?
a) Helper T cells (CD4+)
b) Cytotoxic T cells (CD8+)
c) Regulatory T cells (Tregs)
d) Memory T cells
53. Graft-versus-host disease (GVHD) occurs when:
a) The recipient's immune system attacks the graft.
b) The graft's immune cells attack the recipient's tissues.
c) The graft is infected with a virus.
d) The recipient develops an autoimmune disease.
54. Immunosuppressive drugs used in transplantation primarily target:
a) Antibody production
b) T cell activation and proliferation
c) Complement activation
d) Natural killer cell activity
55. Plasma cell dyscrasias are characterized by:
a) A deficiency of plasma cells.
b) The uncontrolled proliferation of a single clone of plasma cells.
c) An overproduction of different types of antibodies.
d) Impaired B cell development.
56. Monoclonal gammopathy of undetermined significance (MGUS) is:
a) A malignant plasma cell disorder requiring immediate treatment.
b) A benign condition with a small monoclonal protein spike and a low risk of progression to multiple myeloma.
c) A rare form of acute leukemia.
d) An autoimmune disease affecting plasma cells.
57. Multiple myeloma is characterized by:
a) Overproduction of a monoclonal antibody, bone marrow infiltration, and often bone lesions.
b) A deficiency of all immunoglobulin classes.
c) An overproduction of red blood cells.
d) An autoimmune attack on plasma cells.
58. The Bence Jones protein found in the urine of some multiple myeloma patients is:
a) Intact monoclonal immunoglobulin.
b) Free immunoglobulin light chains.
c) Complement component C3.
d) A tumor-specific antigen.
59. Tumor-associated antigens (TAAs) are:
a) Antigens found only on normal cells.
b) Antigens found only on tumor cells and not on normal cells.
c) Antigens expressed at higher levels on tumor cells than on normal cells.
d) Antibodies produced by tumor cells.
60. Which type of immune cell is primarily responsible for killing tumor cells?
a) B lymphocytes
b) Plasma cells
c) Cytotoxic T lymphocytes (CTLs) and Natural Killer (NK) cells
d) Erythrocytes
61. Immune checkpoint inhibitors, used in cancer therapy, work by:
a) Directly killing tumor cells.
b) Blocking inhibitory signals on T cells, allowing them to attack tumor cells more effectively.
c) Stimulating antibody production against tumor cells.
d) Activating complement.
62. Cancer immunotherapy aims to:
a) Suppress the immune system to prevent tumor growth.
b) Enhance the patient's own immune system to recognize and destroy cancer cells.
c) Directly kill cancer cells with targeted drugs.
d) Replace damaged cells with healthy ones.
63. Which of the following is a mechanism by which tumors evade the immune system?
a) Downregulation of MHC class I molecules on tumor cells
b) Production of immunosuppressive cytokines
c) Recruitment of regulatory T cells (Tregs) to the tumor microenvironment
d) All of the above
64. CAR-T cell therapy involves:
a) Injecting patients with antibodies that target tumor cells.
b) Genetically modifying a patient's T cells to express a receptor that recognizes a specific tumor antigen.
c) Stimulating the patient's natural killer cells.
d) Suppressing the patient's immune system.
65. A direct ELISA detects _______, while an indirect ELISA detects _______.
a) Antibodies; antigens
b) Antigens; antibodies
c) Complement; cytokines
d) Cytokines; complement
66. Which of the following is the first serological marker to appear in acute HBV infection?
a) Anti-HBs
b) HBsAg
c) Anti-HBc
d) HBeAg
67. HBsAg (Hepatitis B surface antigen) indicates:
a) Immunity to HBV
b) Previous exposure to HBV
c) Current HBV infection
d) Vaccination against HBV
68. Anti-HBs (antibody to Hepatitis B surface antigen) indicates:
a) Acute HBV infection
b) Chronic HBV infection
c) Immunity to HBV, either from vaccination or past infection
d) Recent exposure to Hepatitis A
69. Which marker indicates high infectivity in a patient with chronic HBV?
a) Anti-HBs
b) HBsAg
c) Anti-HBc
d) HBeAg
70. Anti-HBc (antibody to Hepatitis B core antigen) indicates:
a) Immunity from vaccination
b) Past or present HBV infection
c) Recent exposure to Hepatitis A
d) Absence of HBV exposure
71. IgM anti-HBc indicates:
a) Past HBV infection
b) Chronic HBV infection
c) Acute HBV infection
d) Immunity from vaccination
72. IgG anti-HBc indicates:
a) Acute HBV infection
b) Recent HBV vaccination
c) Past or chronic HBV infection
d) Absence of HBV infection
73. A patient tests positive for HBsAg, HBeAg, and IgM anti-HBc. This indicates:
a) Past HBV infection with immunity
b) Chronic HBV infection with low infectivity
c) Acute HBV infection with high infectivity
d) Vaccination against HBV
74. A patient tests positive for Anti-HBs only. This indicates:
a) Acute HBV infection
b) Chronic HBV infection
c) Immunity from vaccination
d) Past HBV infection with loss of Anti-HBs
75. A patient tests positive for Anti-HBs and Anti-HBc. This indicates:
a) Acute HBV infection
b) Chronic HBV infection
c) Immunity from natural infection
d) Immunity from vaccination
76. A patient tests positive for HBsAg and IgG anti-HBc, but negative for IgM anti-HBc and Anti-HBs. This indicates:
a) Acute HBV infection
b) Chronic HBV infection
c) Past HBV infection
d) Vaccination against HBV
77. What does "window period" in HBV infection refer to?
a) The period after vaccination before Anti-HBs is detectable.
b) The period during chronic infection when HBeAg is undetectable.
c) The period when both HBsAg and Anti-HBs are undetectable, but Anti-HBc is present.
d) The incubation period of HBV before symptoms appear.
78. The goal of Hepatitis B vaccination is to induce:
a) HBsAg
b) Anti-HBc
c) Anti-HBs
d) HBeAg
79. What test is used to measure the amount of HBV DNA in the blood?
a) Anti-HBc
b) HBsAg
c) HBV viral load
d) HBeAg
80. Which serological marker would be expected to disappear first in a patient who is clearing an acute HBV infection?
a) anti-HBc
b) HBsAg
c) anti-HBs
d) IgG anti-HBc
81. The most common initial screening test for HIV infection is:
a) Western blot
b) HIV viral load
c) ELISA or rapid antibody test
d) CD4 count
82. What does the HIV ELISA test detect?
a) HIV DNA
b) HIV RNA
c) Antibodies to HIV
d) HIV p24 antigen only
83. A positive result on an HIV ELISA test requires:
a) Immediate initiation of antiretroviral therapy
b) Confirmation with a more specific test
c) Confirmation with a CD4 count
d) No further testing
84. The confirmatory test for HIV infection in most laboratories is:
a) ELISA
b) HIV viral load
c) Western blot or immunofluorescence assay (IFA)
d) CD4 count
85. The Western blot test for HIV detects antibodies against:
a) A single HIV protein
b) Multiple specific HIV proteins
c) All HIV proteins
d) Only HIV surface proteins
86. During the "window period" of HIV infection:
a) Antibodies are detectable, but the viral load is low.
b) The viral load is undetectable.
c) Antibodies are not yet detectable, even though the virus is present.
d) Symptoms are always present.
87. Which assay directly measures the amount of HIV virus in the blood?
a) ELISA
b) Western blot
c) HIV viral load (e.g., RT-PCR)
d) CD4 count
88. What does a CD4 count measure in HIV-infected individuals?
a) The amount of virus in the blood
b) The number of helper T cells
c) The amount of antibody to HIV
d) The number of B cells
89. A low CD4 count in an HIV-infected individual indicates:
a) A healthy immune system
b) Advanced immunosuppression and increased risk of opportunistic infections
c) Recent HIV infection
d) Resistance to antiretroviral therapy
90. In HIV serology, what does "antigen/antibody combination assay" mean?
a) It detects both HIV antibodies and HIV antigens simultaneously
b) It detects HIV antibodies in one sample and HIV antigens in a separate sample
c) It only detects HIV antigens and antibodies
d) It confirms ELISA results
91. The non-treponemal tests for syphilis detect:
a) Antibodies directed against Treponema pallidumitself.
b) Antibodies directed against cardiolipin, lecithin, and cholesterol released from damaged cells.
c) Treponema pallidum directly.
d) Complement proteins.
92. Examples of non-treponemal tests include:
a) FTA-ABS and TP-PA
b) VDRL and RPR
c) MHA-TP and EIA
d) Darkfield microscopy
93. A positive non-treponemal test should be:
a) Ignored if the patient has no symptoms.
b) Treated immediately without further testing.
c) Confirmed with a treponemal test.
d) Repeated immediately to rule out a lab error.
94. The VDRL test is commonly used to test:
a) Cerebrospinal fluid (CSF) for neurosyphilis
b) Blood for latent syphilis
c) Urine for congenital syphilis
d) Synovial fluid for arthritis
95. Treponemal tests detect:
a) Antibodies to cardiolipin.
b) Treponema pallidum bacteria directly.
c) Antibodies specifically directed against Treponema pallidum.
d) Complement proteins activated by Treponema pallidum.
96. Examples of treponemal tests include:
a) VDRL and RPR
b) FTA-ABS, TP-PA, and EIA
c) Darkfield microscopy
d) Gram stain
97. A positive treponemal test indicates:
a) Active syphilis infection.
b) Past or present syphilis infection.
c) False-positive result.
d) Successful treatment of syphilis.
98. Once a treponemal test is positive:
a) It always remains positive, even after successful treatment.
b) It will always become negative after successful treatment.
c) It will fluctuate between positive and negative.
d) It is repeated annually to monitor disease progression.
99. Which of the following test combinations suggests active syphilis infection?
a) Negative non-treponemal, negative treponemal
b) Positive non-treponemal, positive treponemal
c) Negative non-treponemal, positive treponemal
d) Positive non-treponemal, negative treponemal
100. In the context of syphilis serology, "prozone effect" refers to:
a) A false-negative result due to a very low antibody titer.
b) A false-positive result due to cross-reacting antibodies.
c) A false-negative result due to a very high antibody titer.
d) A false-positive result due to bacterial contamination.
101. Which test can be used to monitor treatment response in syphilis?
a) Treponemal tests
b) Non-treponemal tests
c) Darkfield microscopy
d) PCR for T. pallidum
102. In a patient with suspected secondary syphilis, which test is most likely to be positive at a high titer?
a) FTA-ABS
b) TP-PA
c) RPR
d) Darkfield microscopy
103. What is the recommended screening approach for syphilis?
a) Start with a treponemal test, and confirm positives with a non-treponemal test.
b) Start with a non-treponemal test, and confirm positives with a treponemal test.
c) Always start with a darkfield microscopy
d) Always start with PCR
104. A "biological false positive" in syphilis serology refers to:
a) A false-positive result caused by technical error
b) A false-positive result caused by another underlying condition
c) A false-positive result caused by prozone effect
d) A false-positive result caused by lack of standardization
105. What does reverse sequence screening for syphilis involve?
a) Performing the treponemal test first, followed by the non-treponemal test for confirmation.
b) Performing the non-treponemal test first, followed by the treponemal test for confirmation.
c) Using a new rapid test instead of traditional tests
d) Confirming positive results with darkfield microscopy
106. Serology primarily involves the study of:
a) Cellular components of blood
b) Antigens and antibodies in serum and other bodily fluids
c) Bacterial cultures
d) Genetic mutations
107. An antigen-antibody reaction is based on:
a) Covalent bonding
b) Ionic bonding
c) Hydrogen bonding and van der Waals forces
d) Hydrophobic interactions
108. The strength of the bond between an antigen and an antibody is known as:
a) Valency
b) Avidity
c) Affinity
d) Specificity
109. Which of the following describes the ability of an antibody to bind to a specific epitope?
a) Avidity
b) Affinity
c) Specificity
d) Sensitivity
110. The term "titer" refers to:
a) The size of the antigen
b) The concentration of antibody in a sample
c) The number of cells in a sample
d) The sensitivity of a test
111. In serological testing, a "false positive" result means:
a) The test indicates the presence of an antigen or antibody when it is truly absent.
b) The test fails to detect an antigen or antibody when it is truly present.
c) The test accurately reflects the true status of the sample.
d) The test is unreliable and should not be used.
112. In serological testing, "sensitivity" refers to:
a) The ability of the test to correctly identify those with the disease or condition.
b) The ability of the test to correctly identify those without the disease or condition.
c) The ease of performing the test.
d) The cost of the test.
113. In serological testing, "specificity" refers to:
a) The ability of the test to correctly identify those with the disease or condition.
b) The ability of the test to correctly identify those without the disease or condition.
c) The ease of performing the test.
d) The cost of the test.
114. Agglutination reactions involve:
a) Precipitation of soluble antigens and antibodies
b) Lysis of cells by antibodies and complement
c) Clumping of particulate antigens (e.g., cells or latex beads) by antibodies
d) Neutralization of toxins by antibodies
115. Precipitation reactions involve:
a) Clumping of cells by antibodies
b) Formation of a visible complex between soluble antigens and antibodies
c) Lysis of cells by complement
d) Neutralization of toxins
116. What is the primary advantage of using a labeled immunoassay?
a) Increased sensitivity and specificity compared to unlabeled assays.
b) Lower cost compared to unlabeled assays.
c) Simpler procedure compared to unlabeled assays.
d) No need for controls.
117. A "label" in an immunoassay is used to:
a) Increase the size of the antigen-antibody complex.
b) Make the antigen more immunogenic.
c) Detect and quantify the antigen-antibody complex.
d) Prevent non-specific binding.
118. Which of the following is NOT a common type of label used in immunoassays?
a) Enzymes
b) Radioisotopes
c) Fluorescent dyes
d) Acids
119. In an ELISA (Enzyme-Linked Immunosorbent Assay), the enzyme label:
a) Directly binds to the antigen.
b) Reacts with a substrate to produce a detectable signal.
c) Enhances the antibody's affinity for the antigen.
d) Prevents cross-reactivity.
120. In a direct ELISA, the labeled antibody binds to:
a) The capture antibody.
b) The antigen.
c) The enzyme substrate.
d) The secondary antibody.
121. In an indirect ELISA, the labeled antibody binds to:
a) The antigen.
b) The primary antibody.
c) The enzyme substrate.
d) The capture antibody.
122. A "capture ELISA" is also known as a:
a) Competitive ELISA.
b) Sandwich ELISA.
c) Indirect ELISA.
d) Direct ELISA.
123. In a competitive immunoassay, the amount of signal is:
a) Directly proportional to the amount of antigen in the sample.
b) Inversely proportional to the amount of antigen in the sample.
c) Independent of the amount of antigen in the sample.
d) Always a positive value.
124. Which type of immunoassay uses antibodies attached to a solid surface like a bead or membrane?
a) Homogenous immunoassay
b) Heterogenous immunoassay
c) Radioimmunoassay
d) Enzyme multiplied immunoassay technique (EMIT)
125. What is a major advantage of chemiluminescent immunoassays (CLIAs)?
a) They require no special equipment.
b) They are very inexpensive.
c) They have high sensitivity.
d) They are easy to perform manually.
126. Agglutination reactions involve the:
a) Formation of a visible precipitate from soluble antigen-antibody complexes.
b) Clumping of particulate antigens by antibodies.
c) Lysis of cells by complement.
d) Neutralization of toxins.
127. Direct agglutination occurs when:
a) Antibodies react directly with antigens that are naturally present on a particle (e.g., red blood cells).
b) Antibodies are linked to a carrier particle to enhance agglutination.
c) A second antibody is used to enhance agglutination.
d) Soluble antigens are converted to particulate form.
128. Passive (or Indirect) agglutination occurs when:
a) Antibodies are passively transferred from one individual to another.
b) Antibodies react directly with antigens naturally present on a particle.
c) Soluble antigens are attached to particles (e.g., latex beads) and then react with corresponding antibodies.
d) Only IgM antibodies are involved.
129. Reverse passive agglutination is used to detect:
a) Antibodies in a patient sample.
b) Antigens in a patient sample.
c) Complement activation.
d) Cell lysis.
130. In latex agglutination, the antigen or antibody is coated onto:
a) Red blood cells.
b) Bacteria.
c) Latex beads.
d) Charcoal particles.
131. Precipitation reactions involve the:
a) Clumping of particulate antigens.
b) Formation of a visible insoluble complex from soluble antigens and antibodies.
c) Lysis of cells.
d) Neutralization of toxins.
132. Which of the following factors does NOT influence precipitation reactions?
a) Antigen and antibody concentration
b) Temperature
c) pH
d) Cell size
133. Nephelometry measures:
a) The amount of light absorbed by a solution.
b) The size of agglutinated particles.
c) The amount of light scattered by particles in a solution.
d) The color intensity of a solution.
134. Turbidimetry measures:
a) The decrease in light passing through a solution due to particulate matter.
b) The amount of light emitted by a fluorescent dye.
c) The electrical conductivity of a solution.
d) The number of cells in a solution.
135. Which of the following is true regarding agglutination and precipitation reactions?
a) Agglutination reactions can only be used to detect antibodies.
b) Precipitation reactions can only be used to detect antigens.
c) Agglutination reactions involve soluble antigens, while precipitation reactions involve particulate antigens.
d) Agglutination reactions involve particulate antigens, while precipitation reactions involve soluble antigens.
136. In precipitation reactions, the visible precipitate is formed due to:
a) The clumping of cells by antibodies.
b) The formation of large, insoluble complexes of soluble antigens and antibodies.
c) The lysis of cells by complement.
d) The inactivation of toxins by antibodies.
137. Which precipitation technique involves the diffusion of both antigen and antibody through a gel matrix?
a) Electrophoresis
b) Immunofixation electrophoresis
c) Radial immunodiffusion
d) Double diffusion (Ouchterlony)
138. In radial immunodiffusion, the diameter of the precipitation ring is proportional to:
a) The molecular weight of the antibody
b) The molecular weight of the antigen
c) The concentration of the antigen
d) The concentration of the antibody
139. The Ouchterlony technique is used to determine:
a) The exact concentration of an antigen.
b) The relative specificity and cross-reactivity of antibodies and antigens.
c) The size of particulate antigens.
d) The electrical charge of antigens.
140. In immunoelectrophoresis, the antigen mixture is first separated by:
a) Precipitation with ammonium sulfate.
b) Electrophoresis.
c) Agglutination.
d) Centrifugation.
141. Heterophile antibodies are characterized by their ability to:
a) Specifically target a single antigen.
b) React with antigens from different species or sources.
c) Activate complement.
d) Neutralize toxins.
142. In the context of infectious mononucleosis, heterophile antibodies are primarily detected by which type of test?
a) ELISA for specific EBV antigens
b) Rapid slide agglutination tests (e.g., Monospot test)
c) Western blot for viral proteins
d) PCR for EBV DNA
143. The antigen used in the rapid slide agglutination tests for mononucleosis heterophile antibodies is typically derived from:
a) Epstein-Barr virus itself.
b) Bovine erythrocytes.
c) Human leukocytes.
d) Streptococcus bacteria.
144. A positive heterophile antibody test in a patient with suspected mononucleosis suggests:
a) Definitive confirmation of EBV infection.
b) Recent vaccination against EBV.
c) An immune response to an antigen unrelated to EBV.
d) A possible EBV infection, but further specific testing may be needed, especially in young children.
145. Why might a heterophile antibody test be negative early in the course of infectious mononucleosis?
a) Heterophile antibodies are only produced in chronic EBV infections.
b) The antibody titer may not be high enough to be detected early on.
c) The heterophile antibody response is suppressed by EBV.
d) The wrong type of test was used.
146. The term "febrile antigens" in serology typically refers to:
a) Antigens that cause fever directly.
b) Antigens used to detect antibodies produced in response to febrile illnesses.
c) Antigens that are only expressed at high temperatures.
d) Antigens that suppress the immune system and cause immunosuppression
147. The Widal test is a serological test primarily used for the diagnosis of:
a) Malaria
b) Typhoid fever
c) Dengue fever
d) Tuberculosis
148. The Weil-Felix test is a historically significant serological test used to detect antibodies against:
a) Salmonella species
b) Rickettsial infections
c) Brucella species
d) Hepatitis viruses
149. The serological diagnosis of dengue fever often relies on detecting:
a) Anti-streptolysin O (ASO) titers
b) Febrile agglutinins such as Salmonella O and H antigens
c) IgM and IgG antibodies against dengue virus and/or detection of NS1 antigen
d) Cold agglutinins
150. In acute febrile illness diagnosis, paired sera are often collected to:
a) Reduce cost of testing
b) Monitor changes in antibody titers over time
c) Increase specificity of the test
d) Simplify the testing process