BOC Immunology Test Questions with Verified Answers Rated A
1) Antinuclear antibody tests are performed to help a) indicative of 2 antibodies, which should be
diagnose? separately reported after titration
a) acute leukemia b) expected for anti-DNA antibodies
b) lupus erythematosus c) inconsistent; the test should be reported with new
c) hemolytic anemia reagent
d) Crohn disease - ANSWER -b (lupus d) expected for anti-centromere antibodies -
erythematosus) ANSWER -b (expected for anti-DNA antibodies)
2. In the anti-double-stranded DNA procedure, the 7) The result of an anti-nuclear antibody test was a
antigen most commonly utilized is: titer of 1:320 with a peripheral pattern. Which of the
following sets of results best correlate with these
a. rat stomach tissue results?
b. mouse kidney tissue a) anti-dsDNA titer 1:80, and a high titer of antibodies
c. Crithida lucilia to Sm
d. Toxoplasma gondii - ANSWER -c (Crithida b) antimitochondrial antibody titer 1:160, and
lucilia) antibodies to RNP
c) anti-Scl-70, and antibodies to single-stranded DNA
d) high titers of anti-SS-A and anti-SS-B -
3) Which of the ANA patterns shown above would be ANSWER -a (anti-dsDNA titer 1:80, and a high
associated with high titers of antibodies to the Sm titer of antibodies to Sm)
antigen?
a) diagram A
b) diagram B 8) Systemic lupus erythematosus patients often have
c) diagram C which of the following test results?
d) diagram D - ANSWER -c (diagram C) a) high titers of DNA antibody
b) decreased serum immunoglobulin levels
c) high titers of anti-smooth muscle antibodies
4) Sera to be tested for IFA-ANA 6 days after d) high titers of antimitochondrial antibody -
drawing is best stored at? ANSWER -a (high titers of DNA antibody)
a) room temperature
b) 5°C +/- 2°
c) -70°C in a constant temperature freezer 9. Systemic lupus erythematosus patients with active
d) -20°C in a frost-free self-defrosting freezer - disease often have which of the following test
ANSWER -b (5°C +/- 2°) results?
a. high titers of antimicrosomal antibodies
5) Antibodies directed at native DNA are most b. high titers of anti-smooth muscle antibodies
frequently associated with which pattern of c. marked decrease in serum CH50
fluorescence in the IFA-ANA test? d. decreased serum immunoglobulin levels -
a) rim ANSWER -c (marked decrease in serum CH50)
b) diffuse
c) speckled
d) centromere - ANSWER -a (rim) 10. Which of the following is decreased in serum
during the active stages of systemic lupus
erythematosus?
6) The technologist observes apparent homogenous
staining of the nucleus of interphase cells while a. anti-nuclear antibody
performing an IFA-ANA, as well as staining of the b. immune complexes
chromosomes in mitotic cells. This result is: c. complement (C3)
,BOC Immunology Test Questions with Verified Answers Rated A
d. anti-DNA - ANSWER -c (complement (C3)) connective tissue disease)
11. A positive ANA with the pattern of anticentromere 16) Which of the following is the most sensitive and
antibodies is most frequently seen in patients with: appropriate method for the detection of rheumatoid
factor?
a. rheumatoid arthritis a) nephelometry
b. systemic lupus erythematosus b) immunofixation electrophoresis
c. CREST syndrome c) immunofluorescence
d. Sjӧgren syndrome - ANSWER -c (CREST d) manual latex agglutination - ANSWER -a
syndrome) (nephelometry)
12. In the indirect fluorescent anti-nuclear antibody 17) Rheumatoid factor reacts with:
test, a homogenous pattern indicates the presence of a) inert substances such as latex
antibody to: b) Rh-pos erythrocytes
c) kinetoplasts of Crithidia luciliae
a. RNP d) gamma globulin-coated particles -
b. Sm ANSWER -d (gamma globulin-coated particles)
c. RNA
d. DNA - ANSWER -DNA
18) A consistently and repeatedly negative IFA-ANA
is:
13. In the indirect fluorescent anti-nuclear antibody a) strong evidence against untreated SLE
test, a speckled pattern may indicate the presence of b) associated with active SLE
antibody to: c) characteristic of SLE with renal involvement
d) associated with lupus inhibitor - ANSWER -a
a. histone (strong evidence against untreated SLE)
b. Sm
c. RNA
d. DNA - ANSWER -b (Sm) 19) Positive rheumatoid factor is generally associated
with:
a) hyperglobulinemia
14) A patient has the following test results: b) anemia
c) decreased erythrocyte sedimentation rate
The above results could be seen in patients with: d) azotemia - ANSWER -a (hyperglobulinemia)
a) rheumatic fever
b) rheumatoid arthritis
c) lupus erythematosus 20) The following results are from rubella titer
d) glomerulonephritis - ANSWER -c (lupus performed on acute and convalescent sera using 2-
erythematosus) fold serial dilution:
Date tested: 1/23/04
Acute serum titer: 1:8
15. Autoantibodies in the absence of Sm are found in Convalescent serum titer: 1:32
patients with: After evaluating the above results, best interpretation
is:
a. mixed connective tissue disease a) results are consistent with active infection with
b. systemic lupus erythematosus rubella
c. Crohn disease b) variation in the acute serum titers invalidates these
d. multiple myeloma - ANSWER -a (mixed results
, BOC Immunology Test Questions with Verified Answers Rated A
c) test should be repeated by a different technologist
d) patient was not infected with rubella - 25. False-positive rheumatoid factor in agglutination
ANSWER -a (results are consistent with active and nephelometric methods can be due to elevated
infection with rubella) levels of:
a. cryoglobulin
21) Rheumatoid factors are immunoglobulins with b. histidine-rich-glycoprotein
specificitiy for allotypic determinants located on the: c. aspartame
a) Fc fragment of IgG d. C1q - ANSWER -d (C1q)
b) Fab fragment of IgG
c) J chain of IgM
d) secretory of component of IgA - ANSWER -a 26. An acute phase protein that binds to the
(Fc fragment of IgG) membrane of certain microorganisms and activates
the complements system is:
22) Rheumatoid factor in patients serum may cause a. C-reactive protein
a false: b. tumor necrosis factor alpha
a) positive test for the detection of IgM class c. neutrophils
antibodies d. kinins - ANSWER -a (C-reactive protein)
b) negative test for the detection of IgM class
antibodies
c) positive test for the detection of IgG class 27) High titers of antimicrosomal antibodies are most
antibodies often found in:
d) negative test for the detection of IgG class a) rheumatoid arthritis
antibodies - ANSWER -a (positive test for the b) systemic lupus erythematosus
detection of IgM class antibodies) c) chronic hepatitis
d) thyroid disease - ANSWER -d (thyroid
disease)
23) Rheumatoid factors are defined as:
a) antigens found in the sera of patients with
rheumatoid arthritis 28. Which of the following is an organ-specific
b) identical to the rheumatoid arthritis precipitin autoimmune disease?
c) autoantibodies with specificity for the Fc portion of
the immunoglobulin (IgG) molecule a. myasthenia gravis
d) capable of forming circulating immune complexes b. rheumatoid arthritis
only when IgM-type autoantibody is present - c. Addison disease
ANSWER -c (autoantibodies with specificity for d. progressive systemic sclerosis - ANSWER -c
the Fc portion of the immunoglobulin (IgG) molecule) (Addison disease)
24. Tissue injury in systemic rheumatic disorders 29) In chronic active hepatitis, high titers of which of
such as systemic lupus erythematosus is thought to the following antibodies are seen?
be caused by: a) antimitochondrial
b) anti-smooth muscle
a. Cytotoxic T cells c) anti-DNA
b. IgE activity d) anti-parietal cell - ANSWER -b (anti-smooth
c. deposition of immune complexes muscle)
d. cytolytic antibodies - ANSWER -c (deposition
of immune complexes)
30. In primary biliary cirrhosis, which of the following
1) Antinuclear antibody tests are performed to help a) indicative of 2 antibodies, which should be
diagnose? separately reported after titration
a) acute leukemia b) expected for anti-DNA antibodies
b) lupus erythematosus c) inconsistent; the test should be reported with new
c) hemolytic anemia reagent
d) Crohn disease - ANSWER -b (lupus d) expected for anti-centromere antibodies -
erythematosus) ANSWER -b (expected for anti-DNA antibodies)
2. In the anti-double-stranded DNA procedure, the 7) The result of an anti-nuclear antibody test was a
antigen most commonly utilized is: titer of 1:320 with a peripheral pattern. Which of the
following sets of results best correlate with these
a. rat stomach tissue results?
b. mouse kidney tissue a) anti-dsDNA titer 1:80, and a high titer of antibodies
c. Crithida lucilia to Sm
d. Toxoplasma gondii - ANSWER -c (Crithida b) antimitochondrial antibody titer 1:160, and
lucilia) antibodies to RNP
c) anti-Scl-70, and antibodies to single-stranded DNA
d) high titers of anti-SS-A and anti-SS-B -
3) Which of the ANA patterns shown above would be ANSWER -a (anti-dsDNA titer 1:80, and a high
associated with high titers of antibodies to the Sm titer of antibodies to Sm)
antigen?
a) diagram A
b) diagram B 8) Systemic lupus erythematosus patients often have
c) diagram C which of the following test results?
d) diagram D - ANSWER -c (diagram C) a) high titers of DNA antibody
b) decreased serum immunoglobulin levels
c) high titers of anti-smooth muscle antibodies
4) Sera to be tested for IFA-ANA 6 days after d) high titers of antimitochondrial antibody -
drawing is best stored at? ANSWER -a (high titers of DNA antibody)
a) room temperature
b) 5°C +/- 2°
c) -70°C in a constant temperature freezer 9. Systemic lupus erythematosus patients with active
d) -20°C in a frost-free self-defrosting freezer - disease often have which of the following test
ANSWER -b (5°C +/- 2°) results?
a. high titers of antimicrosomal antibodies
5) Antibodies directed at native DNA are most b. high titers of anti-smooth muscle antibodies
frequently associated with which pattern of c. marked decrease in serum CH50
fluorescence in the IFA-ANA test? d. decreased serum immunoglobulin levels -
a) rim ANSWER -c (marked decrease in serum CH50)
b) diffuse
c) speckled
d) centromere - ANSWER -a (rim) 10. Which of the following is decreased in serum
during the active stages of systemic lupus
erythematosus?
6) The technologist observes apparent homogenous
staining of the nucleus of interphase cells while a. anti-nuclear antibody
performing an IFA-ANA, as well as staining of the b. immune complexes
chromosomes in mitotic cells. This result is: c. complement (C3)
,BOC Immunology Test Questions with Verified Answers Rated A
d. anti-DNA - ANSWER -c (complement (C3)) connective tissue disease)
11. A positive ANA with the pattern of anticentromere 16) Which of the following is the most sensitive and
antibodies is most frequently seen in patients with: appropriate method for the detection of rheumatoid
factor?
a. rheumatoid arthritis a) nephelometry
b. systemic lupus erythematosus b) immunofixation electrophoresis
c. CREST syndrome c) immunofluorescence
d. Sjӧgren syndrome - ANSWER -c (CREST d) manual latex agglutination - ANSWER -a
syndrome) (nephelometry)
12. In the indirect fluorescent anti-nuclear antibody 17) Rheumatoid factor reacts with:
test, a homogenous pattern indicates the presence of a) inert substances such as latex
antibody to: b) Rh-pos erythrocytes
c) kinetoplasts of Crithidia luciliae
a. RNP d) gamma globulin-coated particles -
b. Sm ANSWER -d (gamma globulin-coated particles)
c. RNA
d. DNA - ANSWER -DNA
18) A consistently and repeatedly negative IFA-ANA
is:
13. In the indirect fluorescent anti-nuclear antibody a) strong evidence against untreated SLE
test, a speckled pattern may indicate the presence of b) associated with active SLE
antibody to: c) characteristic of SLE with renal involvement
d) associated with lupus inhibitor - ANSWER -a
a. histone (strong evidence against untreated SLE)
b. Sm
c. RNA
d. DNA - ANSWER -b (Sm) 19) Positive rheumatoid factor is generally associated
with:
a) hyperglobulinemia
14) A patient has the following test results: b) anemia
c) decreased erythrocyte sedimentation rate
The above results could be seen in patients with: d) azotemia - ANSWER -a (hyperglobulinemia)
a) rheumatic fever
b) rheumatoid arthritis
c) lupus erythematosus 20) The following results are from rubella titer
d) glomerulonephritis - ANSWER -c (lupus performed on acute and convalescent sera using 2-
erythematosus) fold serial dilution:
Date tested: 1/23/04
Acute serum titer: 1:8
15. Autoantibodies in the absence of Sm are found in Convalescent serum titer: 1:32
patients with: After evaluating the above results, best interpretation
is:
a. mixed connective tissue disease a) results are consistent with active infection with
b. systemic lupus erythematosus rubella
c. Crohn disease b) variation in the acute serum titers invalidates these
d. multiple myeloma - ANSWER -a (mixed results
, BOC Immunology Test Questions with Verified Answers Rated A
c) test should be repeated by a different technologist
d) patient was not infected with rubella - 25. False-positive rheumatoid factor in agglutination
ANSWER -a (results are consistent with active and nephelometric methods can be due to elevated
infection with rubella) levels of:
a. cryoglobulin
21) Rheumatoid factors are immunoglobulins with b. histidine-rich-glycoprotein
specificitiy for allotypic determinants located on the: c. aspartame
a) Fc fragment of IgG d. C1q - ANSWER -d (C1q)
b) Fab fragment of IgG
c) J chain of IgM
d) secretory of component of IgA - ANSWER -a 26. An acute phase protein that binds to the
(Fc fragment of IgG) membrane of certain microorganisms and activates
the complements system is:
22) Rheumatoid factor in patients serum may cause a. C-reactive protein
a false: b. tumor necrosis factor alpha
a) positive test for the detection of IgM class c. neutrophils
antibodies d. kinins - ANSWER -a (C-reactive protein)
b) negative test for the detection of IgM class
antibodies
c) positive test for the detection of IgG class 27) High titers of antimicrosomal antibodies are most
antibodies often found in:
d) negative test for the detection of IgG class a) rheumatoid arthritis
antibodies - ANSWER -a (positive test for the b) systemic lupus erythematosus
detection of IgM class antibodies) c) chronic hepatitis
d) thyroid disease - ANSWER -d (thyroid
disease)
23) Rheumatoid factors are defined as:
a) antigens found in the sera of patients with
rheumatoid arthritis 28. Which of the following is an organ-specific
b) identical to the rheumatoid arthritis precipitin autoimmune disease?
c) autoantibodies with specificity for the Fc portion of
the immunoglobulin (IgG) molecule a. myasthenia gravis
d) capable of forming circulating immune complexes b. rheumatoid arthritis
only when IgM-type autoantibody is present - c. Addison disease
ANSWER -c (autoantibodies with specificity for d. progressive systemic sclerosis - ANSWER -c
the Fc portion of the immunoglobulin (IgG) molecule) (Addison disease)
24. Tissue injury in systemic rheumatic disorders 29) In chronic active hepatitis, high titers of which of
such as systemic lupus erythematosus is thought to the following antibodies are seen?
be caused by: a) antimitochondrial
b) anti-smooth muscle
a. Cytotoxic T cells c) anti-DNA
b. IgE activity d) anti-parietal cell - ANSWER -b (anti-smooth
c. deposition of immune complexes muscle)
d. cytolytic antibodies - ANSWER -c (deposition
of immune complexes)
30. In primary biliary cirrhosis, which of the following
