IMSE Review Questions
All of the following are protective mechanisms against bacteria, except:
Production of antimicrobial defense peptides
Phagocytosis
Activation of complement
Release of lipid A from bacterial cells
All are characteristics of streptococcal M proteins, except:
It is the chief virulence factor of Group A streptococci
It provokes an immune response
Antibodies to one serotype protect against other serotypes
It limits phagocytosis of the organism
An ASO titer and a streptozyme test are performed on a patient's serum.
ASO titer: Negative
Streptozyme Test: Positive
What can you conclude from these test result?
The ASO is falsely negative
The patient has an antibody to a streptococcal exoenzyme other than streptolysin O.
The patient has not had a previous streptococcal infection
The patient has scarlet fever
Which of the following applies to acute rheumatic fever?
Symptoms begin after S. Pyogenes infection in the throat or the skin
Antibodies to Group A streptococci are believed to cross react with heart tissue
Diagnosis is usually made by culture of the organism
All patients suffer permanent disability
Which of the following indicates the presence of anti-DNAse B activity in serum?
Reduction of methyl green from green to colorless
Clot formation when acetic acid is added
Inhibition of RBC hemolysis
Lack of change in the color indicator
Which of the following is considered to be a nonsuppurative complication of streptococcal infection?
Acute rheumatic fever
Scarlet fever
Impetigo
Pharyngitis
All are ways that bacteria can evade host defenses except:
Presence of capsule
Stimulation of chemotaxis
Production of toxins
Lack of adhesion to phagocytic cells
Antibody testing for Rocky Mountain spotted fever may not be helpful for which reason?
Nonspecific
Too complicated to perform
Blood specimen is difficult to obtain
Antibody production takes at least a week before detection
Which of the following enzymes is used to detect the presence of H. Pylori infections?
DNAse
Hyaluronidase
Urease
Peptidase
Which of the following reasons make serological identification of a current infection with H. Pyloric difficult?
No Abs appear in the blood
Only IgM is produced
Abs remain after initial treatment
No ELISA tests have been developed
M. Pneumoniae infections are associated with the production of:
Cold agglutinins
Anti-ATPase
Anti-DNAse
Anti-Proteus bacteria
Which of the following statements is/are true?
1. Endotoxin is released from the cell wall of the dead bacteria.
2. Exotoxin is released from the cell wall of the dead bacteria.
3. Endotoxin is released from live bacteria.
4. Exotoxin is released from live bacteria.
1 and 2
NOTA
2 and 3
1 and 4
Which of the following statements regarding H. Pylori is not true?
Associated with an increased risk of gastric carcinoma
Major cause of peptic ulcers in the US
Urease positive
All are true.
False positive nontreponemal tests for syphilis may occur because of:
Infectious mononucleosis
SLE
Pregnancy
AOTA
Which test is recommended for testing cerebrospinal fluid for detection of neurosyphilis?
VDRL
RPR
FTA-ABS
Enzyme immunoassay
Which of the following is true about nontreptonemal Abs?
Can be detected in all patients with primary syphilis
Directed against cardiolipin
Remain positive after successful treatment
Only found in patients with syphilis
Which test detects specific treponemal Abs?
RPR
VDRL
FTA-ABS
Agglutination
Viruses can escape immune defenses by:
Undergoing frequent genetic mutations
Suppressing the immune system
Integrating their nucleic acid into the host genome
AOTA
A patient who has developed immunity to a viral infection would be expected to have which of the following serology results?
IgM+, IgG-
IgM-, IgG+
IgM+, IgG+
IgM-, IgG-
A newborn suspected of having a congenital viral infection should be tested for virus-specific Abs of which of the following?
IgA
IgG
IgM
AOTA
IgM anti-HAV = Negative
HBsAg = Positive
IgM anti-HBc = Positive
IgM anti-HCV = Negative
Acute hepatitis B
Chronic hepatitis B
Hepatitis A
Hepatitis C
The serum of an individual who received all doses of the hepa B vaccine should contain:
Anti-HBs
Anti-HBc
Anti-Hbe
AOTA
HIV virions bind to host T cells through which receptors?
CD4 and CD8
CD4 and IL-2
CD4 and CCR5
CD8 and CCR5
Abs to which viral antigens are usually the first to be detected in HIV infection?
Gp120
Gp160
Gp41
P24
Most common means of HIV transmission
Blood transfusion
Intimate sexual contact
Sharing of needles
Transplacental passage
Which of the following combinations of bands would represent a positive Western blot for HIV Ab?
P24 and p55
Gp120 and gp41
P31 and p55
P24 and p31
Characteristic laboratory finding in HIV infection
Decreased numbers of CD4 T cells
Decreased numbers of CD8 T cells
Decreased immunoglobulins
Decreased numbers of CD20 B cells
MATCHING TYPE: ASO Titer
Rising titer
Trend toward recovery
Declining titer
Past infection
Constant titer
Increase in severity of infection
MATCHING TYPE: Hepatitis Serological Markers
Anti-HBe
Earliest serologic marker found in serum during incubation period
HBsAg
Marker for level of virus and infectivity
Anti-HBs
First serologic evidence of convalescent phase
HBeAg
Serologic marker during core window period
Anti-HBc
Serologic marker of recovery and immunity
In health care workers, the risk of contracting hepatitis C is ________ than the risk of contracting AIDS.
Lower
Higher
MATCHING TYPE: Types of Agglutination
Coagglutination
Results in the clumping of red blood cells
Reverse passive
Competition between particulate antigen and soluble antigen for antibody sites.
Direct
Antigens are naturally found on a particle
Hemagglutination
Particles coated with antibodies to detect antigens
Passive
Uses bacteria as the inert particles
Agglutination Inhibition
Particles coated with antigens to detect antibodies.
Direct Antiglobulin Tests (2)
Investigation of HDN
Diagnosis of Hemolytic anemia
Crossmatching
Antibody detection
Antibody identification
A retrovirus enzyme that enables the virus to convert to viral RNA to DNA.
Reverse transcriptase
Reverse oxidase
Reverse transidase
Reverse hydroxidase
HIV chemokine receptor for macrophages and CD4 T cells.
CCR5
CXCR4
CCR2
CXCR5
HIV chemokine receptor for T cells.
CCR5
CXCR4
CCR2
CXCR5
Chemokine receptor used by gp160 to attach to T cells
CCR5
CXCR4
CCR2
CXCR5
A glycoprotein expressed by all dengue viruses that is found 1-9 day after the onset of fever.
Dengue NS-1 Antigen
IgG
IgM
IgM is detectable until _____ after the onset of illness in primary dengue infection.
5-10 days
1-9 days
14th day
4-5 days
IgM is detectable until _____ after the onset of illness in secondary infections.
4-5 days
5-10 days
1-2 days
1-9 days
MATCHING TYPE: Stages of Syphilis
Latent
Condyloma latum
Primary
Gummata; Neurosyphilis
Tertiary
Asymptomatic but highly contagious
Secondary
Painless chancre
Drug of choice for syphilis
Penicillin
Tetracycline
Erythromycin
Primaquine
Which nontreponemal test can be observed macroscopically?
RPR
VDRL
Which of the following makes the reading for RPR result easier?
Choline chloride
Charcoal
Cholesterol
Cardiolipin
Which of the following is used by RPR to inactivate complement without using heat?
Choline chloride
Charcoal
Cholesterol
Cardiolipin
MATCHING TYPE: Precipitation Techniques
Electro-immunodiffusion
Both reactants (Ag&Ab) are diffused within a gel.
Double Immunodiffuson Technique
Precipitin ring forms.
Single Immunodiffusion Technique
Ag/Ab complexes form and precipitate when the two reactant meet at the equivalence zone.
Radial Immunodiffusion
Immunodiffusion reaction in a support medium witht the use of electric current to enhance mobility and movement.
Immuno-fixation Electrophoresis
Antibody is added directly to the surface of the gel.
Immuno-electrophoresis
One reactant (Ag/Ab) remains fixed in a gel.
Ouchterlony Double Diffusion
Antigen is first separated before the addition of antibody.
Mancini
Endpoint diffusion
Longer reaction time
Ag is allowed to diffuse to completion
Kinetic diffusion
Ring diameter=antigen conc.
Ring diameter=log conc.
Measurement is taken before the point of equivalence is reached.
Shorter reaction time
Fahey & McKelvey
Endpoint diffusion
Longer reaction time
Ag is allowed to diffuse to completion
Kinetic diffusion
Ring diameter=antigen conc.
Ring diameter=log conc.
Measurement is taken before the point of equivalence is reached.
Shorter reaction time
Incubation period is 60-90 days.
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis E
The first laboratory screening test of donor blood was for the detection of:
HBc
HBsAg
HBe
Anti-HBe
HbsAg: (-)
Total anti-HBc: (+)
Anti-HBs: (+)
Acute Hepatitis A
Hepatitis A recovery
Acute Hepatitis B
Chronic Hepatitis B
Hepatitis B recovery
Hepatitis B immunization
HBsAg: (+)
Total anti HBc: (+)
IgM anti HBc: (-)
Anti HBs: (-)
Acute Hepatitis A
Hepatitis A recovery
Acute Hepatitis B
Chronic Hepatitis B
Hepatitis B recovery
Hepatitis B immunization
HBsAg: (-)
Anti HBc: (-)
Anti HBs: (+)
Acute Hepatitis A
Hepatitis A recovery
Acute Hepatitis B
Chronic Hepatitis B
Hepatitis B recovery
Hepatitis B immunization
Total anti HAV: (+)
Acute Hepatitis A
Hepatitis A recovery
Acute Hepatitis B
Chronic Hepatitis B
Hepatitis B recovery
Hepatitis B immunization
IgM anti HAV: (+)
Acute Hepatitis A
Hepatitis A recovery
Acute Hepatitis B
Chronic Hepatitis B
Hepatitis B recovery
Hepatitis B immunization
An oxygen stable enzyme that causes hemolysis by disrupting the selective permeability of RBC membrane.
Streptolysin O
Streptolysin S
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