WorksheetsIS FREMEDIAL EXAM
Total questions: 105
Worksheet time: 4hrs 30mins
During a biology class, Abigail learned that a hapten is
Half of an immunoglobulin molecule
A earner molecule for an antigen that is not antigenic alone
An immunoglobulin functional only in the presence of complement
A determinant capable of stimulating an immune response only when bound to a carrier
A 28-year-old female named Ava complains to her family physician of abdominal pain, loss of appetite, and low-grade fever. Physical examination reveals abdominal tenderness and a low-grade fever. Her physician orders a hepatitis profile and obtains the results below.
Anti-HAV: Nonreactive
Anti-HBc: Reactive
Anti-HBs: Nonreactive
HBsAg: Reactive
HBeAg: Reactive
Anti-HCV: Nonreactive
Which of the following is the most likely conclusion?
Acute HAV infection
Acute HBV infection
Chronic HBV infection
Immunity to HBV due to past infection
In a chemiluminescent immunologic assay conducted by Sophia in her lab, what is the signal detected?
Light
An electric signal
A purple-colored compound
A yellow-colored compound
Grace is studying the effects of vaccination against hepatitis B virus (HBV) and learns that it also prevents hepatitis D virus (HDV) infections. Why is this the case?
An immunogen from HBV in the vaccine is also associated with HDV
The HBV vaccine induces formation of heterophile antibodies that cross react with HDV
The HBV vaccine stimulates liver cells to produce antiviral molecules active against all hepatitis viruses
HDV requires the host to be concurrently infected with HBV
Sophia learned in her biology class that B lymphocytes and T lymphocytes are derived from
Hematopoietic stem cells
Macrophages or monocytes
Mucosa-associated lymphoid tissue
The fetal liver
Ava went to the doctor for an allergy test, and the doctor performed a competitive radioimmunosorbent test (RIST). What does a high signal suggest in her test results?
The patient sample has a low concentration of IgE.
The patient sample has a low concentration of IgM
The patient sample has a high concentration of IgE.
The patient sample has a high concentration of total antibody.
Ava developed a rash after using a new skincare product. Her doctor explained that contact dermatitis is mediated by
B lymphocytes
T lymphocytes
Macrophages
Polymorphonuclear cells
In a health clinic, Michael, who is living with human immunodeficiency virus infection, is being monitored for his immune status. The healthcare provider decides to measure the ratio of
CD3+ cells to CD8+ cells
CD4+ cells to CD8+ cells
Lymphocytes to monocytes
T cells to B cells
In a biology class, Benjamin is learning about the immune system. He discovers that cells that can act as antigen-presenting cells for exogenous antigens include
All nucleated cells
Endothelial cells
B lymphocytes
T lymphocytes
A living donor is being sought for a child named Ethan who requires a kidney transplant. The best odds of finding an MHC-compatible donor occur between Ethan and
A sibling (brother or sister)
An unrelated individual
Ethan's father
Ethan's mother
During a routine health check-up, Mason learns that he has been exposed to the hepatitis B virus. The doctor explains that the first serologic marker to appear in patients with acute hepatitis B virus infection is
Anti-HB
Anti-HBc
Anti-HBe
HBsAg
During a biology class, Abigail learned about "Superantigens" which are toxins produced by some strains of Staphylococcus aureus and group A streptococci. Her teacher explained that these toxins cause damage by
Molecular mimicry
Polyclonal T cell activation
Lysing white blood cells and platelets
Lysing red blood cells
Noah recently recovered from a group A streptococcal infection. However, he later developed rheumatic fever, which caused an autoimmune response that attacked the tissue of his heart valves. This phenomenon is an example of
Epitope spreading
Molecular mimicry
Polyclonal B cell activation
Preferential activation of T helper cell
During a health class, Anika learned about various autoimmune diseases. One disease that caught her attention was Hashimoto disease, which primarily involves the
Kidneys
Liver
Lungs
Thyroid gland
Evelyn, a medical student, is conducting an experiment where patient serum is mixed with a suspension of guinea pig antigen. When the sample is then mixed with horse red blood cells, agglutination occurs. This is suggestive of an infection caused by
Borrelia burgdorferi
Hepatitis B virus
Hepatitis C virus
Epstein-Barr virus
Michael visited his doctor after experiencing fatigue and joint pain. A patient report states the presence of serum antibodies to OspC. What disease does Michael most likely have?
Syphilis
Strep throat
Lyme disease
Rubella
During a biology class, Liam learned that the isotype of an immunoglobulin antibody
Is defined by the heavy chain
Is defined as different alleles of the same antibody type (e.g., IgG)
Is constant for all immunoglobulins of an individual
Is the variation within the variable region
During a laboratory class, Daniel was learning about various diagnostic tests. He came across the complement fixation test and wondered what indicator system is used in this test.
Sensitized sheep red blood cells
Fluorescent-labeled antihuman globulin
Enzyme-labeled antihuman globulin
Guinea pig complement
Hannah's serum sample is positive for HBsAg.
This result indicates that the person from whom the serum was taken
Had a hepatitis B infection in the past but overcame the infection
Has either active or chronic hepatitis B infection
Was immunized recently against the hepatitis B virus
Is not infectious for the hepatitis B virus
During a health screening event at the university, William is asked to identify which of the following is an example of a treponemal antigen test used for the diagnosis of syphilis?
CRP
RPR
VDRL
FTA-ABS
During a science experiment, Rohan mixed a soluble antigen with a soluble antibody, and they reacted to form an insoluble product. This process describes
Agglutination reactions
Heterophile reactions
Labeled reactions
Precipitation reactions
During a blood transfusion, Samuel received blood from a donor with a different blood type, leading to a severe reaction. This incident is an example of
Type I hypersensitivity reactions
Type II hypersensitivity reactions
Type III hypersensitivity reactions
Type IV hypersensitivity reactions
Abigail gets a cut on her finger while playing outside, and it becomes contaminated with the bacterium Staphylococcus aureus. The first response by the immune system consists of activity of
B cells
Monocytes
Neutrophils
T cells
During a biology class, Abigail learned about the alternative complement pathway in the immune system.
Can be activated by bacterial capsule polysaccharides
Uses C5b as a C3 convertase
Bypasses steps C3 through C5
Is inactivated by properdin
During a biology lab, Zoe learned about the classical pathway of complement activation,
C3 is activated by binding C-reactive protein
The sequence of activation is Cl, C2, C3,C4
Clq is activated by the presence of a single Fab region
Activation by antibody requires one IgM or two IgG molecules
Aiden went to the doctor for a routine check-up. The doctor decided to test for C-reactive protein (CRP) to assess Aiden's health. Which of the following statements about the test for C-reactive protein (CRP) is true?
It correlates with neutrophil phagocytic function
It is an indicator of ongoing inflammation
It is diagnostic for rheumatic fever
Levels decrease during heart disease.
During a biology class, Charlotte developed a rash after touching a plant that she was allergic to. Which of the following is characteristic of contact hypersensitivity reactions?
Caused by preformed IgE antibody
Characterized by infiltration of neutrophils into the area of reaction
The primary symptoms often occur in the respiratory tract.
Usually due to a hapten
During a biology lab, Abigail and her classmates were discussing the components of the immune system. Luna asked, "Which of the following complement proteins is part of the membrane attack complex?"
Cl
C3
C4
C5
James, a 10-year-old boy, was diagnosed with an autoimmune disease that is causing destruction of his pancreatic cells. His doctor explained that this condition can result in
Hashimoto disease
Multiple sclerosis
Myasthenia gravis
Type 1 diabetes
During a biology lab, Isla and Noah were discussing the various complement proteins found in human serum. Noah asked, "Which complement protein is present in the greatest concentration in human serum?"
Cl
C2
C3
C4
During a class discussion on autoimmune diseases, Aria asked her classmates about the primary mechanism responsible for pathology in systemic lupus erythematosus.
Allergic reaction to foreign molecules
Antibodies directed against self antigens
Polyclonal activation of cytotoxic T cells
Lack of intracellular killing after neutrophil phagocytosis of bacteria
Ava is studying the immune system in her biology class. Her teacher asks the class, "Which of the following is a characteristic of T cells?"
Synthesize antibody
Mature in the thymus
Able to bind unprocessed antigen
Primarily protect against extracellular parasites
In a biology class, Isla and Priya are discussing how B and T helper cells interact in the immune system. They wonder about the specific mechanisms involved in this interaction.
MHC II molecule on B cell binding to MHCI molecule on the T cell
MHC II molecule on B cell binding to CDS on the T cell
Foreign antigen on B cell binding to T cell receptor
CDS molecule on B cell binding to T cell receptor
Lily learned about the activity of natural killer (NK) cells in her biology class.
Does not require previous exposure to an antigen
Involves phagocytosis and killing of bacteria
Requires interaction with cytotoxic T cells
Requires interaction with B cells
During a health class, Zoe learns about various diagnostic tools used in medicine. One topic that comes up is skin testing, which is particularly useful in diagnosing disorders like tuberculosis. Which of the following statements about skin testing is true?
A positive test depends on preformed antibody.
Reactivity to a particular antigen may be transferred from one individual to another by sensitized lymphocytes.
The intensity of the response correlates directly with the clinical activity of the disease
The maximum response will occur immediately
During a biology lab, Grace and Abigail were discussing antibodies. Grace mentioned that antibodies that bind to the same epitope are of the same
Allotype
Autotype
Idiotype
Isotype
In a laboratory, Zoe is learning about how monoclonal antibodies are produced. She discovers that these antibodies are created by
Cultured T cells
Human plasma cells
Mouse plasma cell
Hybridomas
In a biology class, Aria is explaining the structure of an immunoglobulin molecule to her classmates. She mentions, "Which of the following statements applies to the Fc fragment of an immunoglobulin molecule?"
It consists of the entire heavy chain.
It contains the variable region of the heavy chain
It contains the antigen binding sites of the molecule
It is the region of the molecule that binds to receptors on various white blood cells
During a biology class, Aria learned about immunoglobulin light chains. Which of the following statements about immunoglobulin light chains is true?
Each immunoglobulin monomer has either one kappa or one lambda chain.
There are two types: kappa and lambda
They consist of constant regions only.
They form part of the Fc fragment.
In a biology class, Ethan is learning about human cells and their functions. He discovers that a human cell with CDS on its surface is most likely a
B cell
Monocyte
T helper cell
Cytotoxic T cell
During a biology class, Benjamin learned that loss of self-tolerance results in
Autoimmune disease
Graft-versus-host disease
Immunodeficiency
Tumors
During a recent health fair, Luna learned that elevated IgE levels are typically found in certain types of allergic reactions. She was curious about which type of hypersensitivity reaction is associated with high IgE levels.
Type I hypersensitivity reactions
Type II hypersensitivity reactions
Type III hypersensitivity reactions
Type IV hypersensitivity reactions
During a science fair, Jackson is demonstrating the enzyme-linked immunosorbent assay (ELISA) technique. He explains that the visible reaction in his experiment is due to a reaction between
Enzyme and antibody
Enzyme and substrate
Fluorescent dye and antigen
Latex particles and antibody
During a biology class, Maya learned about antibodies and their structure. She discovered that the Fab portion of an antibody
Binds T cell receptor
Consists of two light chains only
Consists of two heavy chains only
Contains the hypervariable region
Ava is feeling unwell and visits her doctor. The doctor decides to perform a serologic test to check for autoimmune disorders using an immunofluorescence method. Which of the following tests is the doctor likely to perform?
Anti-HBs
Antinuclear antibody (ANA)
Antistreptolysin O (ASO)
C-reactive protein (CRP)
During a recent biology lab, Hannah learned that IgM antibodies react well in complement fixation (CF) tests. Because of this, CF tests for antibodies should
Be positive early in the course of the disease
Be useful in identifying antibodies responsible for a delayed hypersensitivity reaction
Be useful in identifying antibodies responsible for anaphylactic reactions
Detect transplacental antibodies
During a science fair, Anika presented her project on antibodies. She explained that identical antibodies produced from a single clone of plasma cells describes a specific type of antibody. What type of antibody is she referring to?
Reagin
Cold agglutinins
Heterophile antibodies
Monoclonal antibodies
During a biology class, Benjamin learned that the portion of an antigen that binds to an antibody or T cell receptor is called a(n)
Allergin
Avidin
Epitope
Valence
During a routine health check, Scarlett received a false-positive result on her VDRL test. One possible cause of this false-positive result is
Brucellosis
Treponema pallidum infection
Rocky Mountain spotted fever
Systemic lupus erythematosus
During a health class, Henry learned about various tests for sexually transmitted infections. He discovered that the Venereal Disease Research Laboratory (VDRL) test for syphilis is classified as a(n)
Agglutination reaction
Flocculation reaction
Hemagglutination reaction
Precipitation reaction
The rapid plasma reagin assay for syphilis does not need to be read microscopically because the antigen is
Cardiolipin
Complexed with latex
Complexed with charcoal
Inactivated bacterial cells
The antibody most frequently present in systemic lupus erythematosus is directed against
Surface antigens of bone marrow stem cells
Surface antigens of renal cells
Nuclear antigen
Myelin
Innate immunity includes
Anamnestic response
Antibody production
Cytotoxic T cell activity
Phagocytosis by polymorphonuclear cells
The type of immunity that follows the injection of antibodies synthesized by another individual or animal is termed
Artificial active
Natural adaptive
Artificial passive
Natural passive
The type of immunity that follows the injection of an immunogen is termed
Artificial active
Natural active
Artificial passive
Natural Passive
After activation of the complement system, leukocytes and macrophages are attracted to the site of complement activation by
C1
C5a
C8
IgM
How does the secondary humoral immune response differ from the primary response?
The lag phase (the time between exposure to immunogen and production of antibody) is longer in the secondary immune response.
IgM is the predominant antibody class produced in the secondary immune response
The antibody levels produced are higher in the secondary immune response
Cytotoxic T lymphocytes play an important role in the secondary response
The strength with which a multivalent antibody binds a multivalent antigen is termed the
Affinity
Avidity
Reactivity
Valence
A major advantage of passive immunization compared to active immunization is that
Antibody is available more quickly
Antibody persists for the life of the recipient
IgM is the predominant antibody class provided
Oral administration can be used
Diagnostic reagents useful for detecting antigen by the coagglutination reaction may be prepared by binding antibody to killed staphylococcal cells via the Fc receptor of staphylococcal protein A. The class of antibody bound by this protein is
IgA
IgD
IgG
IgM
Which cell is the principal source of interleukin 2?
B cell
T cell
Monocyte
Plasma cell
A molecule found in human serum sometimes used as a tumor marker is
a-Fetoprotein
HBsAg
Biotin
CD1
Diagnosis of group A streptococci (Streptococcus pyogenes) infection is indicated by the presence of
Anti-protein A
Anti-DNase B
Anti-beta-toxin
C-reactive protein
In Bruton disease, measurement of serum immunoglobulins would show
Elevated levels of IgE
Elevated levels of IgG
Normal levels of IgG and IgM but reduced levels of IgA
The absence of all immunoglobulins
A kidney transplant from one identical twin to another is an example of a(n)
Allograft
Autograft
Isograft
Xenograft
After exposure to antigen, the first antibodies that can be detected belong to the class
IgA
IgE
IgG
IgM
Corneal tissue may be transplanted successfully from one patient to another because
The cornea is nonantigenic
Corneal antigens do not activate T cells
Anticorneal antibodies are easily suppressed
The cornea occupies a privileged site not usually seen by the immune system
Which one of the following describes a direct immunofluorescence assay?
Conjugated reagent antigen reacts with antibodies to form antigen-antibody complexes
Antigens react with unlabeled antibody forming antigen-antibody complexes that attach to labeled antibodies
A dye is attached to a molecule and it reacts with an immune complex to produce a color
Conjugated reagent antibody reacts with antigen to form antigen-antibody complexes
In individuals allergic to pollen, hyposensitization protocols may be initiated. These individuals receive injections of
Allergen
Pooled human antisera
Monoclonal antibody directed against human T cells
Monoclonal antibody directed against human B cells
Multiple myeloma is a
Lymphoproliferative disease of T cells
Cancer of plasma cells characterized by increased antibody concentration
Lymphoproliferative disease resulting in a decrease in antibody production
Cancer of monocytes characterized by increased kappa and lambda chain synthesis
In bone marrow transplantation, immunocompetent cells in the donor marrow may recognize antigens in the recipient and respond to those antigens. This phenomenon is an example of
Acute rejection
Chronic rejection
Graft versus host disease
Hyperacute rejection
The serologically detectable antibody produced in rheumatoid arthritis (RA) is primarily of the class
IgA
IgE
IgG
IgM
Severe combined immunodeficiency (SCID) is an
Severe combined immunodeficiency (SCID) is an
Immunodeficiency with lymphocytopenia and eosinophil
Immunodeficiency with decreased or dysfunctional T and B cells
Immunodeficiency with decreased lymphocytes and decreased complement concentration
An example of immune injury due to the deposition of antigen-antibody complexes is
Acute glomerulonephritis
Bee-sting allergy
Contact dermatitis
Penicillin allergy
Which class of immunoglobulin binds to basophils and mast cells to mediate immediate hypersensitivity reactions?
IgA
IgD
IgE
IgG
Type I hypersensitivity is
Associated with complement-mediated cell lysis
Due to immune complex deposition
Mediated by activated macrophages
An immediate allergic reaction
The HLA complex is located primarily on
Chromosomes 3
Chromosome 6
Chromosome 9
Chromosome 17
In primary biliary cirrhosis, which of the following antibodies is seen in high titers?
antimitochondrial
anti-smooth muscle
anti-DNA
anti-parietal cell
The simplest test to evaluate the cellular immune system in a patient is a(n):
skin test for commonly encountered antigens
protein electrophoresis of serum
immunoelectrophoresis of serum
measurement of anti-HBsAg after immunization
In assessing the usefulness of a new laboratory test, sensitivity is defined as the percentage of:
positive specimens correctly identified
falsely positive specimens
negative specimens correctly identified
falsely negative specimens
The specificity of an immunoassay is determined by the:
label used on the antigen
method used to separate the bound from free antigen
antibody used in the assay
concentration of unlabeled antigen
Which test has the greatest sensitivity for antigen detection?
precipitin
agglutination
ELISA
complement fixation
A monoclonal spike of IgG, Bence Jones proteinuria, and bone pain are usually associated with:
Burkitt's lymphoma
Burton's disease
severe combined immunodeficiency disease
multiple myeloma
Which of the following fungal agents is a frequent complication of AIDS?
Sporothrix species
Blastomyces species
Histoplasma species
Pneumocystis species
The most sensitive procedure for detection of hepatitis B surface antigen (HBsAg) is:
hemagglutination
counterimmunoelectrophoresis
radial immunodiffusion
ELISA
The serologic test that can be modified to selectively detect only specific IgM antibody in untreated serum is:
complement fixation
immunofluorescence
hemagglutination inhibition
passive hemagglutination
HLA-B8 antigen has been associated with which of the following pairs of diseases?
ankylosing spondylitis and myasthenia gravis
celiac disease and ankylosing spondylitis
myasthenia gravis and celiac disease
Reiter's disease and multiple sclerosis
Which of the following is considered to be a non-suppurative complication of streptococcal infection
Acute rheumatic fever
Scarlet fever
Impetigo
Pharyngitis
M. pneumoniae infections are associated with which antibodies?
Cold agglutinins
Antibodies to ATPase
Antibodies to DNase
Antibodies to Proteus bacteria
Which of the following best describes the principle of the IFA test for detection of antibodies produced in Rocky Mountain spotted fever?
Proteus antigens are used to determine cross-reactivity
A light microscope is used to detect antigen– antibody combination
Whole bacteria are used to detect antibodies
Antibodies are detected by direct fluorescence.
An individual with hepatomegaly, jaundice, and elevated liver enzymes has the following laboratory results: IgM anti-HAV (negative), HBsAg (positive), IgM anti-HBc (positive), and anti-HCV (negative). These findings support a diagnosis of
Hepa A
Acute Hepa B
Chronic Hepa B
Hepa C
Which of the following hepatitis viruses is transmitted by the fecal-oral route?
Hepa B
Hepa C
Hepa D
Hepa E
Quantitative tests for HCV RNA are used to
screen for hepatitis C.
determine the HCV genotype
differentiate acute HCV infection from chronic HCV infection
monitor hepatitis C patients on antiviral therapy
The serum of an individual who received all doses of the hepatitis B vaccine should contain
anti-HBs
anti-HBe
anti-HBc
all of the above
The most common cause of congenital infections is
CMV
Rubella
VZV
HTLV-I
In the laboratory, heterophile antibodies are routinely detected by their reaction with
B lymphocytes.
bovine erythrocyte antigens
sheep erythrocyte antigens
Epstein-Barr virus antigens.
All of the following apply to HIV except
it possesses an outer envelope
it contains an inner core with p24 antigen
it contains DNA as its nucleic acid
it is a member of the retrovirus family
Antibodies to which of the following viral antigens are usually the first to be detected in HIV infection?
gp120
gp160
gp41
p24
Which of the following genes is responsible for the coding of reverse transcriptase
Env
Pol
Gag
Tat
Which of the following is typical of the latent stage of HIV infection?
Proviral DNA is attached to cellular DNA
Large numbers of viral particles are synthesized
A large amount of viral RNA is synthesized.
Viral particles with no envelope are produced.
The decrease in T-cell numbers in HIV-infected individuals is due to
lysis of host T cells by replicating virus
fusion of the T cells to form syncytia
killing of the T cells by HIV-specific cytotoxic T cells
all of the above.
Which of the following combinations of bands would represent a positive Western blot for HIV antibody?
p24 and p55
p24 and p31
gp41 and gp120
p31 and p55
All of the following are likely immunologic manifestations of HIV infection except
decreased CD4 T-cell count.
increased CD8 T-cell count.
increased response to vaccine antigens.
increased serum immunoglobulins
The RT-PCR is a highly sensitive method that involves
direct amplification of HIV RNA
amplification of a label attached to HIV RNA.
amplification of a complementary DNA sequence to a portion of the HIV RNA
DNA sequencing of a portion of HIV RNA.
The most common means of HIV transmission worldwide is through
blood transfusions
intimate sexual contact
sharing of needles in intravenous drug use
transplacental passage of the virus
