You answered the question incorrectly.

Phagocytosis by reticuloendothelial cells is greatly enhanced by:

The correct answer is highlighted below

hemolysins
opsonins
specific antitoxins
protective (neutralizing) antibodies
chemokines

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Opsonins, through a process of opsonization, mark cells, particles, or microbes for

phagocytosis by reticuloendothelial cells.

Question Difficulty: Level 5

You answered the question correctly.

A lymphokine can BEST be described as:

The correct answer is highlighted below

A soluble mediator produced by granulocytes and affecting lymphocytes

A soluble mediator produced by lymphocytes
A soluble mediator produced by plasma cells
An antibody that reacts with lymphocytes

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Lymphokines are a type of cytokine that are produced by lymphocytes, usually T

cells, to direct the immune system response by signaling between its cells.
Lymphokines attract immune cells to an infected area and helps activate them to
attack the foreign pathogens.
 Question Difficulty: Level 5

You answered the question correctly.

A sample of cerebrospinal fluid is diluted 1:100; the standard 9 squares of a

hemocytometer are counted on each side for a total of 18 large squares.

Side 1-- 186 nucleated cells counted

Side 2-- 184 nucleated cells counted

total nucleated cells = 370

Using the standard hemocytometer formula shown on the right, what is the nucleated
cell count per microliter (L)?

The correct answer is highlighted below

1.03 x 104
2.06 x 104
4.62 x 104
9.25 x 104

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Using the formula on the right,

Cells/L = 370 x 100 / 18 x 0.1

Cells/L = 37000 / 1.8

Cells/L = 20556 or 2.06 x 104

Question Difficulty: Level 9

You answered the question incorrectly.
Which is not an application of real-time PCR?

The correct answer is highlighted below

Diagnosis of infectious diseases

Measurement of gene transcription
Drug therapy efficacy
Amplification of DNA for northern blot

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The amplification of DNA for northern blot is not an application of real-time PCR.
However, real-time PCR can be used to: diagnose infectious diseases, measure gene
transcription, measure drug therapy efficacy, and more. In contrast to regular reverse
transcriptase-PCR and analysis by agarose gels, real-time PCR gives quantitative
results. An additional advantage of real-time PCR is the relative ease and convenience
of use compared to some older methodologies.

Question Difficulty: Level 7

You answered the question incorrectly.

In terms of immunology, which one of the following statements is TRUE?

The correct answer is highlighted below

Acute phase proteins help to deactivate the complement process.

Fibronectin opsonizes bacteria and promotes their rapid phagocytosis.
Thiocyanate is a secretory molecule found in skin secretions.
Tumor Necrosis Factor reduces phagocytosis at the site of infection.

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Fibronectin opsonizes bacteria and promotes their rapid phagocytosis. The remaining
choices are incorrect, as acute phase proteins NOT help to deactivate the complement
process, thiocyanate is NOT a secretory molecule found in skin secretions, and tumor
necrosis factor does NOT reduce phagocytosis at the site of an infection.
 Question Difficulty: Level 6

You answered the question incorrectly.

There are two patterns present in this microscopic field from an antinuclear antibody
ANA test. The test is viewed using fluorescent microscopy. One pattern can be seen
in the interphase cells (a) and the area outside of the chromosomal area of the mitotics
(b). The other pattern is recognizable in the chromosomal area of the metaphase
mitotic cells (c). What are these two patterns?

The correct answers are highlighted below

Centromere
Homogeneous
Speckled
Nucleolar

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This is an example of a mix of homogeneous and speckled ANA patterns.

In this sample notice the speckled ANA is the dominant pattern in the interphase cells
(a) and some speckling in the area outside of the chromosomal area of the mitotics
(b).

Also notice the smooth staining of the chromosomal area of the metaphase mitotic
cells (c). This represents the presence of a homogeneous ANA pattern.

Question Difficulty: Level 8

.incorrectlyYou answered the question

The best way to evaluate single nucleotide polymorphism (SNP) is by melting curve
analysis

The correct answer is highlighted below

True
False

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The use of real-time PCR can detect differences as small as one base pair in a DNA
segment.

Question Difficulty: Level 5

You answered the question incorrectly.

Which one of the following statements concerning endocytosis is NOT TRUE?

The correct answer is highlighted below

Cells may employ endocytosis to ingest large polar molecules (macromolecules)

from extracellular fluid.
In endocytosis, the cell membrane often extends outward until it surrounds the
material that will be ingested.
Endocytosis is a natural process of intracellular digestion for nutrition.
Endocytosis is the process by which phagosomes are released by the cell to expel
the macromolecules inside.

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The statement that is not true concerning endocytosis is, "Endocytosis is the process
by which phagosomes are released by the cell to expel the macromolecules inside."
This is the process known as exocytosis, which is the reverse process of endocytosis.
Endocytosis is the process by which cells absorb molecules by engulfing them. It is
used by all cells of the body because most substances important to them are large
polar molecules that cannot pass through the hydrophobic plasma or cell membrane.
All of the remaining answer choices are true concerning endocytosis:
Cells may employ endocytosis to ingest large polar molecules from extracellular fluid.
In endocytosis, the cell membrane extends outward until it surrounds the material that
will be ingested.
Endocytosis is a natural process of intracellular digestion for nutrition.

Question Difficulty: Level 7

You answered the question correctly.

Which of the following kappa / lambda ratios is found in normal serum:

The correct answer is highlighted below

4:1
3:1
2:1
1:1

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The normal kappa/lambda ratio in serum is 2:1. A kappa/lambda ratio outside of 2:1 is
an indication of monoclonal gammopathies.

Question Difficulty: Level 6

You answered the question correctly.

Match these autoimmune diseases with their corresponding serological markers:

Your answers are on the left. The correct answers are on the right and highlighted.
Primary biliary cirrhosis Antimitochondrial antibodies
CREST syndrome Anticentromere antibodies
Wegener's granulomatosis Antineutrophilic antibodies
Rheumatic fever Antimyocardial antibodies

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Rheumatic fever- Antimyocardial antibodies

Wegener's granulomatosis- Antineutrophilic antibodies

CREST syndrome- Anticentromere antibodies

Primary biliary cirrhosis- Antimitochondrial antibodies

Question Difficulty: Level 7

You answered the question incorrectly.

Which of the following are useful serological tests to document antecedent

Streptococcal infections:

The correct answers are highlighted below

ASO
anti-DNAse
M-antigen
Hemolysin

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ASO (antistreptolysin O titer) and DNAse (antideoxyribonuclease-B titer) are tests

that can be used to detect antecedent streptococcal infections. The ASO is usually
utilized to determine whether a previous group A Streptococcus infection has caused a
poststreptococcal disease, such as rheumatic fever, scarlet fever, or
glomerulonephritis. The anti-DNase test is utilized to determine whether a previous
infection of group A beta-hemolytic Streptococcus has occured.

Question Difficulty: Level 6

 You answered the question incorrectly.

This antinuclear antibody (ANA) test pattern is characterized by staining of discrete

speckles in the nucleus of the interphase cells (a) and discrete speckling also in the
chromosomal area of the metaphase mitotics (b) when viewed using fluorescent
microscopy. This image represents which of the following patterns?

The correct answer is highlighted below

Centromere
Unusual speckled
Speckled
Multiple nuclear dots

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This is an example of a centromere ANA pattern.

This pattern is characterized by staining of discrete speckles in the nucleus of the

interphase cells (a). This is staining of the centromere. There are usually 46 speckles,
one for each set of chromosomes. Notice that discrete speckling is also seen in the
chromosomal area of the metaphase mitotics (b).
In order for the ANA to be positive there must be a clearly discernible pattern in the
nucleus of the interphase cells. Metaphase mitotic cells are used to assist in
identification of the ANA pattern.

Question Difficulty: Level 8

You answered the question incorrectly.

Given the following results, what is the immune status of the patient?

HBsAg: negative

HBeAg: negative

Anti-HBc: positive

Anti-HBs: positive

The correct answer is highlighted below

acute infection
chronic infection
recovery
immunization

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If the hepatitis B antigens are no longer present (HbsAg and HbeAg), there is no
longer virus present. The fact that the Anti-HBs and Anti-HBc are BOTH positive,
indicates that there is a recovery process occuring after infection with hepatitis B
virus. It is important to note that Anti-HBs also develops in a person who has been
successfully vaccinated against hepatitis B. Since this patient displayed a positive
Anti-HBc result, immunization could not be the correct answer.

Question Difficulty: Level 6

You answered the question incorrectly.

A cause of FALSE-POSITIVE results in the rapid plasma reagin (RPR) test for
syphilis is:

The correct answer is highlighted below

Gastroenteritis
Gonococcal urethritis
Infectious monocucleosis
Streptococcal pharyngitis

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The RPR test can show false positive results in the absence of syphilis if infectious
mononucleosis, SLE, antiphospholipid antibody syndrome, hepatitis A, leprosy, or
malaria are present.

7.2 mb

246

10gb ggaiv 74

100

Question Difficulty: Level 4

You answered the question correctly.

The use of non-specific fluorescent dyes is the most specific method of measuring
amplicons in real-time PCR.

The correct answer is highlighted below

True
False

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Non-specific fluorescent dyes can bind to both the product and the primers, resulting
in lack of specificity. The use of DNA probes is more specific.
 Question Difficulty: Level 5

You answered the question correctly.

Which complement component is found in both classical and alternative pathways?

The correct answer is highlighted below

C1
C4
factor D
C3
Factor B

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C3 activates both classical and alternative complement activation pathways.

Individuals with C3 deficiency are susceptible to bacteria infection as they will not be
able to mount a complement response against the bacteria.

Question Difficulty: Level 4

You answered the question correctly.

The strength with which a multivalent antibody binds a multivalent antigen is termed
the:

The correct answer is highlighted below

Affinity
Avidity
Reactivity
Valence
Feedback

Avidity is a measure of the overall strength of binding of an antigen with many

antigenic determinants and multivalent antibodies. Avidity is influenced by both the
valence of the antibody and the valence of the antigen.

Question Difficulty: Level 5

You answered the question correctly.

Which of the following immunoglobulin classes is chiefly responsible for the

degranulation of mast cells and basophils:

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IgG
IgA
IgM
IgE

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IgE levels are often increased in patients with allergic disease. IgE binds to the
membranes of mast cells and basophils, and if specific antigen is present to react with
the IgE molecule, degranulation of these cells occurs, releasing histamines, and other
substances into the blood or tissues.

Question Difficulty: Level 5

You answered the question incorrectly.

What is the MOST likely identification of a pink yeast isolate, recovered from
respiratory secretions of a patient with AIDS, that gave the following results?

Germ tube - negative

Urease - positive
Blastospores positive
Arthrospores negative

The correct answer is highlighted below

 Rhodotorula spp.
Cryptococcus spp.
Candida albicans
Trichosporon spp.
Blastomycosis

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Rhodotorula spp. The genus Rhodotorula includes three species including:

Rhodotorula glutinis, Rhodotorula mucilaginosa, and Rhodotorula minuta.
Rhodotorula spp. are occasionally isolated as causative agents of opportunistic
mycoses in vulnerable hosts, including patients with AIDS.

Question Difficulty: Level 8

You answered the question correctly.

How does the secondary immune response differ from the primary immune response?

The correct answer is highlighted below

IgG is the predominant antibody class produced in the secondary immune

response
The antibody levels produced are higher in the secondary immune response
The lag phase (the time between exposure to antigen and production of antibody)
is shorter in the secondary
The primary immune response typically does not involve specific IgG antibody
All of the above

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All of the above choices are correct when differentiating the secondary immune
response differ from the primary immune response. In the secondary immune
response:

IgG is the predominant antibody class produced in the secondary immune

response
The antibody levels produced are higher in the secondary immune response
 The lag phase (the time between exposure to antigen and production of
antibody) is shorter in the secondary
The primary immune response typically does not involve specific IgG
antibody

Question Difficulty: Level 3

You answered the question incorrectly.

Which method remains the gold standard for ANA detection?

The correct answer is highlighted below

Radioimmunoassay (RIA)
Lateral Flow Immunoassay
Enzyme Immunoasay (ELISA)
Slide-based immunofluorescent assay (IFA) or Colorzyme

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Slide-based ANA tests using HEp-2 or HEp-2000 cells are the gold standard.
Dozens of different antibodies can be detected using slide-based assays. Solid phase
assays such as bead and ELISA assays lack sensitivity, resulting in an unacceptable
number of false negative results.

RIAand Lateral flow are not methods used for ANA testing.

Question Difficulty: Level 6

You answered the question correctly.

Which of the following would be considered most significant as it relates to

serological testing:

The correct answer is highlighted below

 Presence of an antibody titer is generally diagnostic
Rise of antibody titers is diagnostic
Concentration of antibody is diagnostic
Cross reactivity is not significant

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Serological diagnosis of active of recent infection generally requires the

demonstration of IgM antibody, or the demonstration of a fourfold rise in the titer of
specific IgG antibody.

Question Difficulty: Level 5

You answered the question incorrectly.

Which of these may contribute to the development of an autoimmune disease?

(Choose all that apply)

The correct answers are highlighted below

Genetic predisposition
Exposure to a triggering event
Low birth weight
Gender

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Genetic predisposition may make some individuals more susceptible to development

of an autoimmune disease. An event that triggers the body to perceive antigens as
foreign may also lead to the development of an autoimmune disease. Another factor is
gender; women are more likely to develop an autoimmune disease.

There is no evidence that low birth weight would lead to development of an

autoimmune disorder.

Question Difficulty: Level 7

 You answered the question correctly.

The 5' end of a DNA strand ends with a OH group.

The correct answer is highlighted below

True
False

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The 5' end of a DNA strand is distinguished by a phosphate while the 3' end is
distinguished by a OH group.

Question Difficulty: Level 6

You answered the question incorrectly.

The hepatitis B virus vaccine was administered to MLS students during

Orientation.Which type of immunity is expected to develop and provide long-term
protection?

The correct answer is highlighted below

active
passive
adoptive
innate
inactive

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The hepatitis B vaccine is a series of immunizations consisting of three injections of

the hepatitis B antigen. The antigen causes the recipient of the injection to make
antibodies against the antigen, hence why this is an example of active immunity.
 Question Difficulty: Level 6

You answered the question correctly.

Match the names of the PCR stages to their definitions.

Your answers are on the left. The correct answers are on the right and highlighted.

The DNA is heated to break the hydrogen bonds resulting in single

Denaturation
stranded DNA.
The DNA primers attach to the DNA strands. Annealing
The DNA polymerase synthesize new strands of DNA. Extension

Question Difficulty: Level 5

You answered the question correctly.

Given the following results, what is the immune status of the patient?

HbsAg: positive

HbeAg: positive

Anti-HBc IgM: positive

Anti-HBs: negative

The correct answer is highlighted below

acute infection
chronic infection
immunization
susceptible

Feedback

HbsAg is positive in acute and chronic Hepatitis B infections, since the antigen is
found on the actual surface of the virus. HbeAg is present in the blood when the
hepatitis B viruses are replicating, indicating an active infection. Anti-Hbc IgM is
present due to the immune response to the presence of the hepatitis core antigen and
indicates an acute infection. Anti-HBs is generally interpreted as indicating recovery
and immunity from hepatitis B virus infection, according to the CDC.

Question Difficulty: Level 6

You answered the question incorrectly.

The properties of an antibody class are defined by the:

The correct answer is highlighted below

size of the immune complex

nature of the stimulating antigen
Fab end of the molecule
Fc end of the molecule
antigen-antibody reaction complex

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The portion of antibodies where the C terminal region of each glycoprotein chain is
located, is called the Fc portion. The Fc portion has a constant amino acid sequence
that defines the class and subclass of each antibody. The Fc portion is responsible for
the biological activity of the antibody. Depending on the class of antibody, some of
the functional activities of the Fc portion of antibodies include activating the
complement pathway and binding to natural killer cells, phagocytosis, basophils, etc.

Question Difficulty: Level 7

You answered the question correctly.

A hapten is only antigenic when it is coupled with which of the following:

The correct answer is highlighted below

Enzymes
 Proteins
Lymphocytes
Lipids

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The molecular weight of a hapten is by itself not sufficient to elicit an antibody

response alone, but requires a protein to do so.

Question Difficulty: Level 4

You answered the question correctly.

B lymphocytes and T lymphocytes are derived from:

The correct answer is highlighted below

Hematopoietic stem cells

Macrophages or Monocytes
Mucosa-associated lymphoid tissue (MALT)
The fetal liver
Bone marrow

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All lymphocytes originate, and are therefore derived from, hematopoietic stem cells
via hematopoiesis. The stem cells eventually mature into common lymphoid
progenitor cells. The progenitor cells then differentiate into their distinct lymphocyte
types. B cells mature into B lymphocytes in the bone marrow, while T cells migrate to
and mature in the thymus.

Question Difficulty: Level 6

You answered the question correctly.

Which two of the following characteristics are common to both RNA and DNA?

The correct answers are highlighted below

Exists primarily as a single-stranded molecule.

Consists of a sugar, phosphate residue, and a purine or pyrimidine base.
Contains the pyrimidine, uracil.
Linked by phosphodiester bonds.

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Both DNA and RNA consist of a sugar, phosphate residue and a purine or pyrimidine
base.

Both DNA and RNA bases are linked by phosphodiester bonds.

DNA is a double-stranded molecule and RNA is single-stranded.

Both DNA and RNA use the same purine bases: adenine and guanine. However, in
DNA the pyrimidines are cytosine and thymine and in RNA, the pyrimidines are
cytosine and uracil.

Question Difficulty: Level 5

You answered the question correctly.

Patients with Waldenstrom's macroglobulinemia demonstrate excessively increased

concentrations of which of the following?

The correct answer is highlighted below

IgG
IgM
IgA
IgD
IgE

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Waldenstrom's macroglobulinemia is the result of lymphoplasmacytic lymphoma
typically characterized by the production of a large amount of monoclonal IgM
antibody.

Question Difficulty: Level 5

You answered the question correctly.

What temperature is considered optimal for Taq polymerase activity?

The correct answer is highlighted below

20oC
72oC
95oC

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Taq polymerase has optimal activity at 72C but can survive up to 95C.

Question Difficulty: Level 5

You answered the question correctly.

Which of these is NOT considered one of the systemic autoimmune rheumatic

diseases?

The correct answer is highlighted below

Systemic lupus erythematosus (SLE)

Systemic sclerosis (SSc)
Rheumatoid arthritis (RA)
Hashimoto disease of the thyroid

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Hashimoto disease of the thyroid is not a systemic autoimmune disease; it is an organ-
specific autoimmune disease. That is, the autoantibodies are directed at a single target
organ (in this case, the thyroid).

SLE, SSc, and RA are all considered systemic autoimmune rheumatic diseases
because they can effect multiple systems in the body (systemic) including the joints,
muscles and bones (rheumatic).

Question Difficulty: Level 4

You answered the question incorrectly.

In real-time PCR procedures, fluorescence resonance energy transfer (FRET) is the

process that allows for probes to emit fluorescence only after hybridization.

The correct answer is highlighted below

True
False

Question Difficulty: Level 4

You answered the question correctly.

Given the following results, what is the immune status of the patient?

HbsAg - neg
HbeAg - neg
Anti-Hbc - neg
anti-HBs - pos
anti-HBe - neg

The correct answer is highlighted below

acute infection
chronic infection
immunization
susceptible
Feedback

Anti-HBs is expected to be positive post-vaccination. Since there are no other

antigens or corresponding antibodies present in the patient sample, it is likely that
patient has been immunized to hepatitis B and is no longer susceptible.

Question Difficulty: Level 4

You answered the question incorrectly.

Which antinuclear antibody (ANA) testing pattern shown below is homogeneous?

Note: (a) points to the nucleus (nuclei) of the interphase cell(s), the primary
consideration for discerning the ANA pattern and (b) indicates the metaphase mitotic
cells. Observing the chromosomal area and cytoplasm of the metaphase cell may
assist in identification of the ANA pattern.

The correct answer is highlighted below

Pattern A

Pattern B
 Pattern C

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In order for the ANA test to be positive there must be a clearly discernible pattern in
the nucleus of the interphase cells. Metaphase mitotic cells are used to assist in
identification of the ANA pattern.
Pattern A is homogeneous. This pattern is characterized by smooth staining in the
nucleus of the interphase cells (a). The nucleoli may or may not stain. Notice the
smooth staining in the chromosomal area of the metaphase mitotic cells (b).

Pattern B is nuclear membrane. This pattern is characterized by smooth staining in the

nucleus of the interphase cells (a). The nucleoli may or may not stain. Notice however
the chromosomal area of the metaphase mitotic cells is negative (b).

Pattern C has no clearly discernable pattern in the nucleus of the interphase cells (a).
However, there is a discernable pattern staining in the cytoplasm (b). This pattern is
characteristic of anti-golgi antibodies.

Question Difficulty: Level 6