Test Bank for Contemporary Clinical Immunology and Serology by Ritten house Olson – Test Bank

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Test Bank for Contemporary Clinical Immunology and Serology by Ritten house Olson – Test Bank

 

Sample  Questions

 

Chapter 3   Antigens-Epitopes and Immunogenicity

 

Multiple-Choice Questions

 

 

1. All cells in the body can get infected, and when infected, a cell presents the antigen of the infection. In which molecule does it present the antigen, and which type of cell responds?
a. class II molecule, CD4+ T cell
b. class I molecule, CD8+ T cell
c. immunoglobulin, NK cell
d. PAMP, PRRs

 

2. Because I want to create a helper T cell response that will help create a cytotoxic response, I am going first to load the MHC molecule myself artificially. To fit the MHC molecule that I want and create the first response that I want, what peptide size should I use and what cytokine(s) do I hope will be secreted?
a. 13–18 amino acids and IL-12 by the antigen-presenting cell to create a TH1 response
b. 8–10 amino acids and IL-4 by the antigen-presenting cell to create a TH2 response
c. 13–18 amino acids and IL-2 by the antigen-presenting cell to create a TH2 response
d. 8–10 amino acids and IL-12 by the antigen-presenting cell to create a TH2 response

 

3. If the antigen is mixed with oil and water to make an emulsion prior to immunization,
a. the oil and water acts as an adjuvant to allow slow release of the antigen
b. the oil and water acts as a lipid to make the antigen more hydrophobic, so it is more antigenic
c. the oil and water are used just to get the antigen into solution
d. this will decrease the immune response

 

4. If mom is HLA A2A9/B5B12/CW3CW5 and baby is A2A11/B5B18/Cw5Cw8, can a man who is A9A11/B8B18/CW5CW8 be the dad? Can a child who is A2A9/B5B18/Cw5Cw8 be the sibling without recombinational events?
a. yes and yes
b. yes and no
c. no and yes
d. no and no

 

5. An adjuvant
a. is covalently attached to a carrier to form an immune response
b. allows slow release of the antigen to increase immunogenicity
c. is covalently attached to a hapten to form an immune response
d. is an alloantigen on the immunoglobulin molecule

 

6. Which of the following are either a and b or g and d, have a variable region that was formed through recombinational events, and are associated with the CD3 molecule  ?
a. IgD molecules
b. acute phase reactants
c. pattern recognition receptors
d. T-cell receptors

 

7. Which of the following is true for cross-reactions? They
a. can hurt us because they can be related to autoimmune disease
b. are the reason that we have anti-A or anti-B red blood cell antibodies
c. cause the need for a very specific assay for HCG for pregnancy testing
d. are used in vaccines
e. can do all of the above

 

8. An antigen on an extracellular bacterium
a. is presented after ingestion by an antigen-presenting cell in a class I molecule after binding in the rough endoplasmic reticulum
b. is presented after ingestion by an antigen-presenting cell after the relevant antigenic peptide has been processed into pieces that are 13–18 amino acids long and the class II molecule has lost the invariant chain in the lysosome and has picked up the processed peptide
c. is presented after ingestion by an antigen-presenting cell in a class II molecule after binding in the rough endoplasmic reticulum
d. is presented after ingestion by an antigen-presenting cell after the relevant antigenic peptide has been processed into pieces that are 13–18 amino acids long, and the class I molecule has lost the invariant chain in the lysosome and has picked up the processed peptide

 

9. Which of the following is the most immunogenic?
a. Streptococcal polysaccharide
b. DNA from a hepatitis B virus
c. the protein toxoid from tetanus
d. the lipids isolated from the milk of a cow with an udder infection

 

10. Regarding a molecule that is involved in presenting antigens from cells that are infected, what is the molecule, what size antigen is placed in these molecules, and to what cells does it present the antigen?
a. class II molecule, 8–10 amino acids, the CD4+ T cell
b. class I molecule, 13–16 amino acids, the CD8+ cell
c. class I molecule, 8–10 amino acids, the CD 8+ cell
d. class II molecule, 13–18 amino acids, the CD8+ cell

 

11. An adjuvant is
a. a bacterial strain that has undergone a mutation to become worse
b. a helper virus that allows bacterial growth
c. a substance that can increase recruitment of cells to participate in an immune response and cause slow release of the antigen
d. any organism that helps another organism proliferate

 

12. If mom is HLA A1A9/B5B12/CW3CW5 and baby is A9A11/B5B18/Cw5Cw8, can a man who is A9A1/B8B18/CW5CW8 be the dad? Can a child who is A9A11/B12B18/Cw5Cw8 be the sibling without a recombinational event?
a. yes and yes
b. yes and no
c. no and yes
d. no and no

 

13. An alloantigen is
a. an antigen from a different part on your own body
b. an antigen from a different individual in your same species
c. an antigen from another species that is recognized by surface carbohydrates
d. an antigen from a different species that is recognized by surface proteins

 

14. It has been theorized that some viruses have antigens on their surfaces similar to human antigens, which can lead to the reaction of the immune system with self-antigens that are slightly different from the virus as the result of
a. homeopathic effect
b. opsonic effect
c. cross-reactivity
d. polyclonal response

 

15. An antigen on an intracellular bacteria
a. is presented after infection by the infected cell in a class I molecule after binding in the Golgi
b. is presented after ingestion by an antigen-presenting cell after the relevant antigenic peptide has been processed into pieces that are 13–18 amino acids long, and the class II molecule has lost the invariant chain in the lysosome and picked up the processed peptide
c. is presented after ingestion by an antigen-presenting cell in a class II molecule after binding in the rough endoplasmic reticulum
d. is presented after ingestion by an antigen-presenting cell after the relevant antigenic peptide has been processed into pieces that are 13–18 amino acids long, and the class I molecule has lost the invariant chain in the lysosome and picked up the processed peptide

 

16. Which of the following is the most immunogenic?
a. Hemophilus influenza polysaccharide
b. DNA from a Herpes virus
c. protein toxoid from tetanus
d. lipids isolated from an atherosclerosis plaque

 

17. A heteroantigen is
a. an antigen from a different part on your own body
b. an antigen from a different individual in your same species
c. an antigen from another species that is recognized by surface carbohydrates and does not follow an evolutionary pattern of inheritance
d. an antigen from a different species

 

18. An alloantigen is
a. an antigen from an immunologically privileged site that has been released due to injury
b. an antigen from a different species
c. an antigen from another member of the same species
d. an antigen that is not inherited as expected

 

19. Class I molecules are found on
a. every nucleated cell in your body
b. red blood cells only
c. monocytes, macrophage, dendritic cells, and B cells only
d. B and C

 

20. The T cell receptor
a. is associated with the CD3 receptor on the cell surface
b. binds soluble antigen
c. only binds antigen which is presented by the correct MHC class I or II molecule
d. A and B
e. A and C

 

21. Class II molecules
a. have a bound invariant chain that must be removed before antigenic peptides can bind
b. present antigen to CD4 + T cells
c. present antigen to CD8+ T cells
d. A and B

 

22. Which of the following contains factors involved in immunogenicity?
a. charge, foreignness, chemical complexity
b. molecular weight, foreignness, chemical complexity
c. charge, foreignness, molecular weight
d. charge, molecular weight, chemical complexity

 

23. An exogenous antigen is defined as
a. any foreign antigen presented to a T cell
b. an alloantigen presented to a B cell
c. an antigen that comes from outside the cell and has been engulfed by an antigen-presenting cell
d. an antigen that comes from an intracellular bacteria or virus that after digestion replaces the invariant chain

 

24. Epitopes are the
a. part of the antibody molecule that binds to the antigen
b. part of the antigen that binds to the binding site of the antibody
c. outermost part of the protein
d. outermost part of a carbohydrate

 

25. An immunogen is a(n)
a. compound that is capable of eliciting an immune response in a host
b. antigen that is from other members of the same species as the host
c. restricted portion of a molecule involved in the actual binding with the combining site of a particular antibody
d. small compound that, although able to combine with elements of the immune system such as antibodies, cannot stimulate an immune response unless they are linked to a much larger immunogenic molecule called a carrier

Chapter 5 Complement Pathways

 

Multiple-Choice Questions

 

1. Complement has
a. about 9 different proteins that are synthesized by monocytes
b. about 35 different proteins that are synthesized by monocytes
c. about 9 different proteins that are synthesized by monocytes, the liver, macrophages, and epithelial cells
d. about 35 different proteins that are synthesized by monocytes, the liver, macrophages, and epithelial cells

 

2. Susie has an acute infection—strep throat—and her friend Zoe has a chronic illness, systemic lupus erythematosus.
a. Susie probably has an elevated CH 50 while Zoe probably has a decreased CH50.
b. Susie probably has a decreased CH 50 while Zoe probably has an increased CH50.
c. Both Susie and Zoe probably have an elevated CH 50.
d. Both Susie and Zoe probably have a decreased CH 50.

 

3. Complement proteins are involved in all of the following except
a. host defense
b. immune complex clearance
c. interaction with the coagulation pathway
d. lattice formation
e. enhancement of memory

 

4. C1q can
a. bind free-floating IgM that is not bound to antigen
b. become activated after interaction with one surface-bound antibody
c. bind after a conformational change occurs as the result of antigen binding
d. bind IgG4

 

5. What molecule is needed for C1q,r and s to stay together?
a. Mg++
b. Ca++ and Mg++
c. Ca++
d. none of the above

 

6. Sometimes a microorganism can directly activate complement through
a. the alternative pathway only
b. the lectin pathway only
c. the alternative and the lectin pathway
d. usually the alternative and the lectin pathways, but with some microorganisms, also the classical pathway

 

7. The difference in the three pathways is the way the C3 convertase is formed
a. in the classical pathway, the C3 convertase is C1C2; in the alternative pathway, it is C3wBb; and in the MBL pathway, the C3 convertase is C2aC4b
b. in the classical pathway, the C3 convertase is C2aC4b’ in the alternative pathway, it is C3wBb; and in the MBL pathway, the C3 convertase is C2aC4b
c. in the classical pathway, the C3 convertase is C1C2; in the alternative pathway, it is C3wBb; and in the MBL pathway, the C3 convertase is MBL-MASP-2
d. in the classical pathway, the C3 convertase is C2aC4b; in the alternative pathway, it is PDBb; and in the MBL pathway, the C3 convertase is C2aC4b

 

8. Amplification steps in the complement pathways occur
a. in the classical pathway with C1 cleaving multiple molecules of C4 and multiple C2 for every C1 and C4; in the alternative pathway with the C3b of other pathways becoming C3 convertase; and then the C3b becoming part of a C5 convertase
b. in all pathways with all the C3 convertases making multiple C3a +C3b
c. with C9 polymerization
d. all of the above
e. A and B only

 

9. The AH50 differs from the CH50 because the AH50
a. measures the alternative pathway and the CH50 measures the classical pathway
b. measures the classical pathway and the CH50 measures the alternative pathway
c. uses rabbit red blood cells and the CH50 uses sheep red blood cells with antibody
d. measures the alternative pathway and the CH50 measures the classical pathway and uses rabbit red blood cells and the CH50 uses sheep red blood cells with antibody
e. measures the classical pathway and the CH50 measures the alternative pathway and uses rabbit red blood cells and the CH50 uses sheep red blood cells with antibody

 

10. Complement proteins are synthesized by
a. the liver
b. monocytes
c. macrophages
d. epithelial cells
e. All of the above

 

11. Properdin is a
a. complemencomponent of the classical pathway
b. complement protein of the alternative pathway
c. complement protein of the lectin pathway
d. defensin

 

12. Inhibitors of complement include
a. factors I, H, and C1INH
b. vitronectin or S protein
c. CR3
d. factors I, H, and C1INH and vitronectin or S protein
e. All of the above

 

13. If the CH50 is lower than normal but the AH50 is normal, which set contains the components that could be involved?
a. factor B, factor D, and Properdin
b. MBL, MASP-1, MASP-2
c. C1, C4, C2, C1INH
d. C5-9

 

14. Anaphylatoxins include
a. C5a
b. C4a
c. C3a
d. C5a and C4a
e. all of the above

 

15. Which of the following are anaphylatoxins?
a. C1q, C2a, C4a
b. C2b, C4a, C5a
c. C2a, C4a, C5a
d. C3a, C4a, C5a

 

16. Which of the following are all opsonic molecules?
a. C3b, C1q, iC3b, C4b
b. C2a, C1q, C3b
c. C2b, C3b, C4b
d. C3b, C4b, C9

 

17. Which of the following is correct?
a. C1INH inactivates C1 and inhibits binding of MBL to MASP-2.
b. factor D inhibits factor B and Properdin.
c. DAF inhibits C1q binding to C1r and C1s.
d. CR2 inhibits C3b formation.

 

18. Complement can lyse which of the following cells?
a. fungal cells
b. gram-positive bacteria
c. gram-negative bacteria
d. all of the above

 

19. Individual complement components measured with
a. AH50
b. CH50
c. RID
d. bacterial cell lysis

 

20. We would expect that a patient who has chronic liver disease would have complement levels that would be
a. elevated
b. normal
c. decreased
d. indeterminate because there is too little information

 

21. To study antibody in a patient’s blood in a way that removes the complement,
a. freeze and thaw the serum
b. use serum instead of plasma
c. add LPS and then heat to 100°C for 2 minutes
d. heat the serum to 56oC for 30 minutes

 

22. Complement
a. causes lysis of gram-positive cells and has no effect on gram-negative cells
b. causes lysis of gram-negative cells and has no effect on gram-positive cells
c. causes lysis of gram-positive cells and increases the amount of phagocytosis of gram-negative cells
d. causes lysis of gram-negative cells and increases the amount of phagocytosis of gram-positive cells

 

23. Complement
a. aids in immune complex clearance
b. interacts with the coagulation pathway
c. can be involved in immune memory enhancement
d. all of the above
e. A and C only

 

24. The three different pathways of complement activation are
a. different until the C5 convertase is formed
b. different until the membrane attack complex forms
c. different until activation of C3
d. different until C6 convertase forms

 

25. Which of the following is an active C3 convertase?
a. C4bC2a
b. C3bC5b
c. C4bC2a
d. BbDd

 

26. Calcium ions are required
a. to keep C4bC2a together
b. to keep C6,7,8 together
c. to allow C9 to polymerize
d. to keep C1q,r,s together

 

27. C-reactive protein can
a. activate complement in the classical pathway
b. activate complement in the lectin pathway
c. activate complement in the alternative pathway
d. activate complement in the classical pathway and activate complement in the alternative pathway

 

28. Because a particular antigen is far on the bacteria from another antigen, antibodies binding to these antigens
a. would activate complement only if antibodies bound to them underwent a comformational shift
b. would activate complement only if antibodies bound to them were close enough for the Fc regions of the bound antibodies to bind different globular heads of the C1q molecule
c. would activate complement only if antibodies bound to them underwent a comformational shift and would activate complement only if antibodies bound to them were close enough for the Fc regions of the bound antibodies to bind different globular heads of the C1q molecule
d. none of the above

 

29. Which of the following has a short half-life unless it lands on the cell surface?
a. C4b
b. C2b
c. C5a
d. C3a

 

30. Which pathway(s) can act as a powerful amplifier of the other pathways?
a. the classical pathway
b. the alternative pathway
c. the lectin pathway
d. all of the pathways can amplify each other

 

31. Which is involved in immune complex clearance by phagocytosis or splenic clearance?
a. CR1
b. CR2
c. CR3
d. CR1 and CR3

 

32. Collectin is
a. another name for the mannose-binding lectin
b. a name for the collective processes involved in all complement pathways
c. a receptor for C3b
d. a receptor for C1q

 

33. MBL binds
a. mannose and MASP-2 become associated and cleave C2 and C4
b. mannose and MASP-1 become associated and cleave C4
c. ficolin and MASP-2 become associated and cleave C2 and C4
d. membranes and MASP-1 become associated and cleave C2 and C4

 

34. The factors in the alternative pathway that are involved in the progression of the pathway are_______ and ___________. The factors that are involved in inhibition of the pathway are _____ and _________.
a. Factor C and D , Factor Properdin and Factor I
b. Factor B and D , Factor E and F
c. Factor B and D, Factor ficolin and Factor I
d. Factor B and D, Factor H and I

Chapter 7 Labeled Immunoassays

 

Multiple-Choice Questions

 

1. Which of the following is a homogeneous assay?
a. a sandwich assay
b. an immunocolloid assay
c. a fluorescence polarization immunoassay
d. a multiplex assay

 

2. You have a patient who has rheumatoid factor. If you are performing an assay for various infectious diseases in which you capture the patient’s IgM, add the antigen, and then add a labeled antibody to the antigen, the
a. reactions with all antigens tested would be positive
b. reactions with all antigens tested would be negative
c. controls would be negatively affected
d. assay would not be affected

 

3. To remove the effect of a patient’s rheumatoid factor, the
a. patient’s sample could be diluted in a buffer containing IgG that does not react with the test antigen
b. assay should be run at 37 Cº instead of at room temperature
c. patient’s sample could be diluted in nonfat dried milk
d. patient’s serum could be diluted in a buffer containing mouse immunoglobulin

 

4. A western blot differs from a recombinant immunoblot because
a. the antigens on the nitrocellulose strip in the western blot have been blotted directly onto the blot but the antigens on the recombinant immunoblot are electrophoresed onto the blot
b. because the antigens on the nitrocellulose strip in the western blot have been electrophoresed and then blotted onto the blot and the recombinant immunoblot the antigens are just pipetted onto the blot
c. because in a western a direct EIA is performed and in a recombinant immunoblot an indirect EIA is performed
d. because in a western an indirect EIA is performed and in a recombinant immunoblot an indirect EIA is performed

 

5. In analysis of a multiplex bead,
a. one-color fluorescence is measured from the indirect immunoassay
b. one-color fluorescence is measured from the indirect immunoassay signal and one blended color is measured from the bead
c. two-color fluorescence is measured from the indirect immunoassay signal, and 100 different colors are measured from each bead
d. two-color fluorescence is measured from the direct immunoassay signal, and 100 different colors are measured from each bead

 

6. Which two labeled immunoassays do not require instrumentation?
a. colloid immunoassay and chemiluminescent assay
b. fluorescent immunoassay and optical immunoassay
c. colloid immunoassay and optical immunoassay
d. fluorescent immunoassay and a colorimetric enzyme immunoassay

 

7. In a competitive immunoassay, the
a. amount of signal is directly proportional to the amount of patient’s antibody and can be determined from a standard curve
b. amount of signal is inversely proportional to the amount of patient’s antibody and can be determined from a standard curve
c. amount of signal is proportional to the square of the patient’s antibody concentration
d. amount of signal is inversely proportional to the square of the antibody concentration

 

8. For a small antigen with one epitope that is in the fluid phase, the best assay would be
a. a capture assay
b. a competitive assay
c. a direct immunofluorescent assay
d. nephelometry

 

9. An additional advantage of an indirect assay is that
a. the indirect step amplifies the reaction and makes the assay more sensitive
b. the indirect step allows for the determination of the class (isotype) of the antibody that is bound
c. A and B
d. none of the above

 

10. The kit for the homogeneous assay for methamphetamine comes with methamphetamine linked to glucose-6-phosphate dehydrogenase, and antibody to the drug blocks the action of the enzyme when the patient’s serum contains
a. the drug and there is more enzyme reactivity
b. the drug and there is less enzyme reactivity
c. low levels of the drug and there is less enzyme reactivity than without the patient’s serum
d. high levels of the drug and there is less enzyme reactivity than without the patient’s serum

 

11. To measure the amount of a 200,000-molecular-weight-tumor antigen in a patient’s blood, the best assay is
a. a direct enzyme immunoassay
b. an indirect immunoassay
c. a sandwich immunoassay
d. none of the above

 

12. The presence of human heterophilic antibody is
a. difficult to predict
b. the result of the patient’s interactions with animals of the species used to make the antibody in the assay
c. can cause false positive reactions in capture assays
d. all of the above

 

13. A indirect radioimmunoassay uses a different second antibody binding step because of the radiolabel but the same first antibody binding step as
a. an indirect enzyme immunoassay
b. an indirect fluorescent immunoassay
c. capture assay
d. A and B

 

14. Advantage(s) of an indirect assay is(are) that
a. the indirect step amplifies the reaction and makes the assay more sensitive
b. the indirect step allows for the determination of the class (isotype) of the antibody that is bound
c. A and B
d. none of the above

 

15. In the homogeneous assay for methamphetamine, the kit comes with methamphetamine linked to glucose-6-phosphate dehydrogenase, and antibody to the drug blocks the action of the enzyme when the patient’s serum contains
a. low levels of the drug and there is less enzyme reactivity than without the patients serum
b. high levels of the drug and there is less enzyme reactivity than without the patient’s serum
c. the drug and there is more enzyme reactivity
d. the drug and there is less enzyme reactivity

 

16. In analysis of a multiplex bead
a. two-color fluorescence is measured from the indirect immunoassay signal, and 100 different colors are measured from each bead
b. two-color fluorescence is measured from the direct immunoassay signal, and 100 different colors are measured from each bead
c. one-color fluorescence is measured from the indirect immunoassay
d. one-color fluorescence is measured from the indirect immunoassay signal and one blended color is measured from the bead

 

17. Which of the following requires a trigger to measure the signal?
a. a fluorescent immunoassay
b. an enzyme immunoassay
c. a chemiluminescent assay
d. a colloid immunoassay

 

18. A indirect radioimmunoassay uses a different second antibody-binding step because of the radiolabel, but the same first antibody binding step is
a. an indirect enzyme immunoassay
b. an indirect fluorescent immunoassay
c. a capture assay
d. all of the above

 

19. In a sandwich assay,
a. the antibody is sandwiched between a capture antigen and a labeled antigen
b. the antigen is sandwiched between a capture antibody and a labeled antibody
c. either A or B
d. none of the above

 

20. HAMA
a. is human anti-mouse antibody
b. can cause false positives in capture immunoassays
C can cause false negative reactions in capture immunoassays
c. A and B
d. A and C

 

21. The presence of human heterophilic antibody
a. is difficult to predict
b. results from the patient’s interactions with animals of the species used to make the antibody in the assay
c. can cause false positive reactions in capture assays
d. all of the above

 

22. Which of the following assays uses a trigger before the signal can be read?
a. a homogeneous assay
b. a radioimmunoassay
c. a fluorescent immunoassay
d. a chemiluminescent assay

 

23.  


The reaction shown in the figure is

 

a. a sandwich immunoassay
b. a capture immunoassay
c. an indirect immunoassay
d. a direct immunoassay
e. A and B

 

24. In the following two reactions, the test tube is washed and centrifuged and only the reaction on the beads stays in the tube. The reaction on the right
a. includes the addition of the patient antigen and results in increased color
b. includes the patient antigen and results in decreased color
c. is a heterogeneous assay
d. makes this a capture assay

 

25. Optical immunoassays are based on
a. a change in the color of light reflected from the surface when ag and ab are bound
b. a change in color seen in a fluorescent immunoassay
c. the use of immunochromatography
d. chemiluminescence
Answers A

 

26. In a capture assay for IgM that reacts with rubella, an antibody to human IgM binds the patient IgM, rubella antigen from the kit is added, and then an enzyme labeled antibody to rubella is added. What would happen to this assay if the patient had rheumatoid factor but no IgM antibodies to rubella?
a. The patient would appear positive for IgM rubella antibodies unless bovine serum albumin was added as a nonspecific blocker.
b. The patient would appear positive for IgM rubella antibodies unless nonfat dried milk was added as a nonspecific blocker.
c. The patient would appear positive for IgM rubella antibodies unless human IgG that did not react with rubella was added as a specific blocker.
d. The patient would appear negative for IgM rubella antibodies unless human IgG that did not react with rubella was added as a specific blocker.

 

27. Which is most sensitive?
a. an Ouchterlony reaction
b. an agglutination reaction
c. a homogeneous labeled immunoassay
d. a heterogeneous labeled immunoassay

 

28. The first labeled assays developed were
a. radioimmunoassay
b. chemiluminescent immunoassays
c. enzyme immunoassays
d. fluorescent immunoassays

 

29. A fluorescent polarization assay is
a. an inhibitory labeled immunoassay
b. a multiplex assay
c. a heterogeneous labeled immunoassay
d. a homogeneous labeled immunoassay

 

30. Which of the following assays requires a trigger
a. a colloid immunoassay
b. a chemiluminescent assay
c. a radioimmunoassay
d. a fluorescent immunoassay

 

31. Two assays which are often used for point of care tests are
a. optical immunoassays and radioimmunoassay
b. optical immunoassays and colloid immunoassays
c. enzyme immunoassays and fluorescent immunoassays
d. multiplex assays and colloid immunoassays

 

32. The best name for the assay in the figure below would be

 

a. a capture enzyme immunoassay
b. a double capture enzyme immunoassay
c. a direct enzyme immunoassay
d. an indirect enzyme immunoassay

 

33. In the assay in the preceding figure, if the patient had rheumatoid factor
a. the test would be a false negative
b. and high titers of the antibody to the antigen, the test would be a false negative
c. the test results would be unaffected
d. the test would be a false positive

 

34. In a sandwich assay
a. the antibody is sandwiched between a capture antigen and a labeled antigen
b. the antigen is sandwiched between a capture antibody and a labeled antibody
c. either A or B
d. none of the above

 

35. HAMA
a. is human anti-mouse antibody
b. can cause false positives in capture immunoassays in which monoclonal antibodies are used
c. can cause false negative reactions in capture immunoassays in which mouse monoclonal antibodies are used
d. A and B
e. A and C

Chapter 9 Hypersensitivity Reactions

Multiple-Choice Questions

 

1. Which of the following is correct?
a. type I IgG to cell surface antigens, type II IgE allergic reaction, type III immune complexes, type IV cellular reaction
b. type I IgE allergic reaction, type II IgG to cell surface antigens, type III immune complexes, type IV cellular reaction
c. type I IgE allergic reaction, type II cellular reaction, type III immune complexes, type IV IgG to cell surface antigens
d. type I IgE allergic reaction, type II immune complexes, type III cellular reaction, type IV IgG to cell surface antigens

 

2. After antigen-stimulated production of IgE and upon second exposure to the antigen, the antigen
a. forms immune complexes with circulating IgE and then binds to mast cells, and the IgE becomes cross-linked
b. forms immune complexes with circulating IgA and then binds to mast cells, and the IgE becomes cross-linked
c. binds to IgE bound to mast cells, and the IgE becomes cross-linked
d. binds to IgE bound to granulocytes and activates a calcium ion channel

 

3. In a transfusion reaction,

 

a. the antibody can bind to surface antigens of red blood cells and activate complement
b. the antibody can bind to the surface of red blood cells, which can become phagocytized because of the surface Fc regions
c. the antibody can bind to the surface of red blood cells, which can become phagocytized because of the surface Fab regions
d. A and B

 

4. A farmer was cleaning out the grain silo in the early fall, getting it prepared for fresh grain. There was an area to which she paid special attention because it had some mold, and it is important to disinfect it prior to addition of the new grain. This happened last year as well. During the initial stages of the cleanup, the air was full of the mold’s smell and actually became cloudy in an area around her. Twelve hours later, she began to have respiratory symptoms that resulted from a hypersensitivity reaction. Upon testing her sera in an Ouchterlony reaction, she had an obvious precipitin reaction. The reaction seen in her lungs is similar to the reaction seen on the Ouchterlony. She has a

 

a. type I hypersensitivity reaction
b. type II hypersensitivity reaction
c. type III hypersensitivity reaction
d. type IV hypersensitivity reaction

 

5. An example of a type I hypersensitivity reaction is
a. an allergic reaction to the gold in a ring
b. a transfusion reaction
c. the allergic reaction to poison ivy
d. the allergic reaction to peanuts

 

6. IgE-mediated reactions seem counterintuitive in relation to survival of the fittest because it seems strange that a response that can cause life-threatening results would be preserved.,  However, IgE-mediated responses can be protective in responses to pathogens
a. by clearing the gastrointestinal tract via vomiting and diarrhea
b. by contracting or blocking airways
c. by increasing fluids and blood flow to allow better access to immune and inflammatory components to the site of an attack
d. all of the above

 

7. The mast cell is armed with surface immunoglobulin during the

 

a. sensitization phase
b. activation phase
c. effector phase
d. implementation phase

 

8. Which of the following are early mediators of type I hypersensitivity?
a. leukotrienes, platelet activating factors, histamines, prostaglandins
b. histamines, prostaglandins, cytokines, serotonin
c. histamines, prostaglandins, IL-4, serotonin, altered phospholipids
d. histamines, prostaglandins as well as eosinophil chemotaxins, serotonin

 

9. Two people are allergic to ragweed, but Bill of them has mild symptoms in his nose and eyes whereas the Sue experiences severe asthma. There are 17 species of ragweed. What are possible reasons for the difference in their symptoms?

 

a. The pollen that Sue, the person with asthma is allergic to may be smaller in molecular weight and thus go more deeply into her lungs  and in addition Sue may have more IgE to the allergen than Bill.
b. The pollen that Sue, the  person with asthma is allergic to may be larger in molecular weight and thus go more deeply into ther lungs and in addition she may have more IgE to the allergen.
c. The pollen that Bill, person with mild symptom is allergic to may be larger in molecular weight and thus go more deeply into his lungs and he may have more IgE to the allergenso the reaction occurs as soon as the allergen enters.
d. The pollen that Bill, the person with mild symptom is allergic to may be smaller and thus go more deeply into his lungs and and he may have more IgE to the allergen and thus he would experience the reaction as soon as the allergen enters.

 

10. Two children in a family are half sisters; that is, their mom remarried so they both have the same mom but different fathers. The oldest child has severe allergies to dust, eggs, pollen, and chocolate, but the mom, the second child’s dad and the second child have no allergies at all. The oldest child may have inherited from her dad
a. an MHC haplotype that favors a TH1 response
b. an MHC haplotype that favors a TH2 response
c. a genetic variation that causes increased production of cytokines that favor IgE production
d. A and/or C
e. B and/or C

 

11. A RIST is a(n) ___________; a RAST is a(n) ______________.
a. indirect assay; capture assay
b. direct assay; indirect assay
c. capture assay; capture assay
d. capture assay; indirect assay

 

12. Controls for a skin test for allergy include
a. a ppd reaction and saline
b. a ppd reaction and histamine
c. a ppd reaction and a tine test
d. saline and histamine

 

13. For hyposensitization,
a. small amounts of allergen are given orally in hope of creating tolerance
b. small amounts of allergen are given in hope of stimulating regulatory T cells
c. small amounts of allergen are given in hope of creating an IgG response
d. none of the above

 

14. Who is given RH immune globulin?
a. an RH(D) positive baby who has mom’s antibody on his red blood cells to block lysis
b. an RH (D) positive dad prior to conception, so he will produce only an RH negative child
c. an RH (D) negative mom so that she will not make anti-RH
d. an RH (D) positive mom so that she will not make anti-RH
e. A and C

 

15. What type of function do tissues injured in type III hypersensitivity often have?
a. filtering
b. respiratory
c. digestive
d. metabolic

 

16. The symptoms of an immediate hypersensitivity reaction depend upon

 

a. where the antigen enters the body
b. how much allergen enters the body
c. how much IgE the patient has made
d. all of the above

 

17. An immunoassay has a solid matrix with a specific test allergen on its surface.
a. This will be part of a RAST and will be an indirect assay.
b. This will be part of a RIST and will be a capture assay.
c. This will be part of a skin test.
d. This could be any of the above.

 

18. The purpose of hyposensitization is to develop

 

a. IgM that binds to the allergen to block the IgE binding
b. IgG that crosses the placenta to protect the infant from endemic diseases
c. IgG that binds to the allergen to block the IgE binding
d. IgG in a new type of vaccine to block HIV entry from hypodermic injections

 

19. An example of a type II hypersensitivity disease is

 

a. SLE
b. rheumatoid factor
c. Goodpasture’s disease
d. A and B

 

20. This figure shows a skin reaction that developed as the result of the reaction of the individual to a ring that was not pure gold but was alloyed with nickel. The reaction appeared 2 days after wearing the ring. This rash is

 

 

a. pemphigus vulgaris.
b. It is an IgE-mediated reaction
c. It is a type III hypersensitivity. reaction.
d. It is a type IV hypersensitivity reaction.
e. A and D

 

21. The assay that measures the amount of the patient’s total IgE is

 

a. RIST
b. RAST
c. a capture immunoassay
d. A and C
e. B and C

 

22. Skin testing uses

 

a. an intramuscular injection of the antigen for allergy testing
b. an intradermal injection of the antigen for allergy testing
c. a saline negative control and a histamine positive control
d. A and C
e. B and C

 

23. Hemolytic anemias are mediated by

 

a. type I hypersensitivity
b. type II hypersensitivity
c. type III hypersensitivity
d. type IV hypersensitivity

 

24. The indirect antiglobulin test, or IAT, is used when

 

a. testing a woman’s blood for antibody to the Rh antigen
b. testing a baby’s red blood cells to see whether they are coated with antibody
c. vaccinating a patient to have them make IgG instead of IgE
d. none of the above
e. A and B

 

25. A positive tuberculin tine test
a. is a type IV hypersensitivity reaction
b. is a type III hypersensitivity reaction
c. has fibrin in it, which makes the reaction site hard as well as raised
d. A and C
e. B and C

 

26. The first time Susie had strawberries, she had a wonderful seafood meal for the second time in a month. After dinner, she experienced hives and vomiting and diarrhea.

 

a. The rash indicates that she must be allergic to the strawberries, and the diarrhea indicates that she probably had food poisoning as well.
b. The rash indicates that she must be allergic to the strawberries, and the diarrhea indicates that she probably is also allergic to the seafood.
c. Both the rash and the diarrhea are probably due to her seafood allergy that is showing clinical symptoms for the first time.
d. The rash is due to her seafood allergy, and the diarrhea must be due to hepatitis because allergies do not cause diarrhea.