TEST BANK
Immunology and Serology in Laboratory Medicine
Mary Louise Turgeon
7th Edition
,Table of Contents
Chapter 01 Highlights of the Innate and Adaptive Immune Systems 1
Chapter 02 Soluble Mediators of the Immune System 9
Chapter 03 Antigens and Antibodies 14
Chapter 04 Innate and Adaptive Immunology-Cellular Functions and Related Clinical
Disorders 21
Chapter 05 Safety in the Immunology-Serology Laboratory 28
Chapter 06 Quality Assurance and Quality Control 32
Chapter 07 Basic Serologic Laboratory Techniques 38
Chapter 08 Precipitation and Particle Agglutination Methods 43
Chapter 09 Electrophoresis Techniques 50
Chapter 10 Labeling Techniques in Immunoassay 54
Chapter 11 Flow Cytometry 60
Chapter 12 Molecular Laboratory Techniques 63
Chapter 13 Infectious Diseases-Traditional and Alternate Diagnostic Techniques 69
Chapter 14 Streptococcal Infections 89
Chapter 15 Syphilis 95
Chapter 16 Vector-Borne Diseases 99
Chapter 17 Infectious Mononucleosis 104
Chapter 18 Viral Hepatitis 110
Chapter 19 Primary and Acquired Immune Deficiency Syndromes 115
Chapter 20 Hypersensitivity Reactions 123
Chapter 21 Immunoproliferative Disorders 129
Chapter 22 Tolerance, Autoimmunity, and Autoimmune Diseases 136
Chapter 23 Systemic Lupus Erythematosus 142
Chapter 24 Rheumatoid Arthritis 148
Chapter 25 Transplantation-HLA, Solid Organ, and Hematopoietic Stem Cells 153
Chapter 26 Tumor Immunology and Up-to-Date Applications of Next-Generation
Sequencing 159
Chapter 27 Primer on Vaccines 162
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Test Bank - Immunology and Serology in Laboratory Medicine, 7th Edition (Turgeon, 2022)
Chapter 01: Highlights of the Innate and Adaptive Immune Systems
Turgeon: Evolve Resources for Immunology & Serology in Laboratory Medicine, 7th
Edition
MULTIPLE CHOICE
1. The “father” of immunology is generally considered to be
a. Koch.
b. Pasteur.
c. Gram.
d. Salk.
ANS: B
Louis Pasteur is generally considered to be the “father of immunology.”
DIF: Cognitive Level: I
2. An early form of immunization was practiced by the
a. Romans.
b. Greeks.
c. Chinese.
d. Native Americans.
ANS: C
Beginning about 1000 AD, the Chinese practiced a form of immunization by inhaling dried
powders derived from the crusts of smallpox lesions.
DIF: Cognitive Level: I
3. A specific function of the immune system is to
a. recognize self from nonself.
b. defend the body against nonself.
c. amplify specific functions.
d. Both A and B.
ANS: D
The function of the immune system is to recognize self from nonself and defend the body
against nonself. Such a system is necessary for survival. The immune system also has
nonspecific effector mechanisms that usually amplify the specific functions. Nonspecific
components of the immune system include mononuclear phagocytes, polymorphonuclear
leukocytes, and soluble factors (e.g., complement).
DIF: Cognitive Level: I
4. An undesirable consequence of immunity is
a. natural resistance.
b. acquired resistance to infectious diseases.
c. an autoimmune disorder.
d. recovery from infectious disease.
ANS: C
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Test Bank - Immunology and Serology in Laboratory Medicine, 7th Edition (Turgeon, 2022)
The desirable consequences of immunity include natural resistance, recovery, and acquired
resistance to infectious diseases. A deficiency or dysfunction of the immune system can cause
many disorders. Undesirable consequences of immunity include allergy, rejection of a
transplanted organ, or an autoimmune disorder.
DIF: Cognitive Level: I
5. The immune system has various distinctive characteristics except;
a. specificity.
b. memory.
c. mobility.
d. noncooperation among different cells.
ANS: D
The immune system is composed of a large, complex set of widely distributed elements, with
the distinctive characteristics of specificity, memory, mobility, replicability, and cooperation
among different cells or cellular products. Specificity and memory are characteristics of
lymphocytes in the immune system. Nonspecific elements of the immune system demonstrate
mobility. In addition, specific and nonspecific cellular components of the immune system can
replicate. Cooperation is required for optimal functioning, and interaction involves specific
cellular elements, cell products, and nonlymphoid elements.
DIF: Cognitive Level: I
6. Hematopoiesis occurs in the yolk sac during the
a. immediate hours after conception
b. second month of gestation.
c. second trimester of gestation.
d. periods of severe anemia in children.
ANS: A
The sites of blood cell development, or hematopoiesis, follow a definite sequence in the
embryo and fetus. Hematopoiesis occurs in the yolk sac during the second month of gestation.
DIF: Cognitive Level: II
7. The sequence of blood cell development in the embryo and fetus is
a. yolk sac, liver-spleen, bone marrow.
b. yolk sac, bone marrow, liver/spleen.
c. liver-spleen, yolk sac, bone marrow.
d. bone marrow, liver-spleen, yolk sac.
ANS: A
The first blood cells are primitive red blood cells (erythroblasts; RBCs) formed in the islets of
the yolk sac during the first 2 to 8 weeks of life. Gradually, the liver and spleen replace the
yolk sac as the sites of blood cell development. By the second month of gestation, the liver
becomes the major site of hematopoiesis, and granular types of leukocytes have made their
initial appearance. The liver and spleen predominate from about 2 to 5 months of fetal life. In
the fourth month of gestation, bone marrow begins to produce blood cells. After the fifth fetal
month, bone marrow begins to assume its ultimate role as the primary site of hematopoiesis.
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DIF: Cognitive Level: II
8. The primary function of mature neutrophils is
a. to reduce inflammation.
b. to lyse parasites in the circulatory system.
c. antigen recognition.
d. phagocytosis.
ANS: D
Various phagocytic cells continually circulate throughout the blood, lymph, gastrointestinal
system, and respiratory tract. When trauma occurs, the neutrophils arrive at the site of injury
and can be found in the initial exudate in less than 1 hour. Monocytes are slower in moving to
the inflammatory site. Macrophages resident in the tissues of the body are already in place to
deal with an intruding agent. Additional macrophages from the bone marrow and other tissues
can be released in severe infections.
DIF: Cognitive Level: II
9. Primary granules, or azurophilic granules, in neutrophils contain
a. lysozyme.
b. myeloperoxidase.
c. lactoferrin.
d. Both A and B.
ANS: D
Granules in the phagocyte cytosol contain degradatory enzymes of three types
1. Primary, or azurophilic, granules containing enzymes (e.g., lysozyme,
myeloperoxidase)
2. Secondary, or specific, granules containing substances such as lactoferrin.
3. Tertiary granules containing substances such as caspases
DIF: Cognitive Level: I
10. The origin of a condition when eosinophils are increased in the circulating blood is associated
with:
a. fungus
b. parasitic amoeba
c. allergic reactions
d. bacteria
ANS: C
An increase in eosinophils is associated with a wide variety of conditions, but especially with
allergic reactions, drug reactions, certain skin disorders, parasitic infestations, collagen
vascular diseases, Hodgkin disease, and myeloproliferative diseases.
A functional property related to the membrane receptors of the eosinophil is the cell’s ability
to interact with the larval stages of some helminth parasites and damage them by oxidative
mechanisms. Certain proteins released from eosinophilic granules damage antibody-coated
Schistosoma parasites and may account for damage to endothelial cells in hypereosinophilic
syndromes.
DIF: Cognitive Level: I
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Test Bank - Immunology and Serology in Laboratory Medicine, 7th Edition (Turgeon, 2022)
11. A basophil degranulates in a(n)
a. inflammatory reaction.
b. immediate (acute) hypersensitivity reaction.
c. chronic tissue rejection.
d. Both A and B.
ANS: B
Basophils have high concentrations of heparin and histamine in their granules. If events are
triggered by antigens from pollen, food, drugs, or insect venom, the result is an immediate
hypersensitivity reaction.
DIF: Cognitive Level: II
12. Mononuclear cells are effective phagocytic cells against
a. staphylococci.
b. streptococci.
c. Mycobacterium tuberculosis.
d. pneumonia.
ANS: C
Mononuclear cells are particularly effective as phagocytic cells because of the large amounts
of lipase in their cytoplasm. Lipase is able to attack bacteria with a lipid capsule, such as
Mycobacterium tuberculosis.
DIF: Cognitive Level: I
13. Macrophages
a. process antigens.
b. physically present biologically modified antigens to lymphocytes.
c. secrete a lymphocyte-activating factor (IL-1) as a result of proper MHC
recognition.
d. All of the above.
ANS: D
The phagocytic property of the macrophage is particularly important in the processing of
antigens as part of the immune response. Macrophages are believed to process antigens and
physically present this biochemically modified and more reactive form of antigen to
lymphocytes (particularly T helper cells) as an initial step in the immune response.
DIF: Cognitive Level: II
14. Cell-mediated immunity is moderated by
a. B lymphocytes.
b. T lymphocytes.
c. monocytes-macrophages.
d. Both B and C.
ANS: D
Cell-mediated immunity is moderated by the link between T lymphocytes and phagocytic
cells (i.e., monocytes-macrophages).
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DIF: Cognitive Level: I
15. B lymphocytes respond to
a. antigens presented on the surface of an antigen-presenting cell.
b. antigens on microorganisms or other living cells.
c. native antigenic determinants of appropriate fit.
d. antigens floating in body fluids.
ANS: C
The B type of lymphocyte can probably respond to a native antigenic determinant of the
appropriate “fit.”
DIF: Cognitive Level: I
16. T lymphocytes respond to
a. antigens presented on the surface of an antigen-presenting cell.
b. antigens on microorganisms or other living cells.
c. native antigenic determinants of appropriate fit.
d. antigens floating in body fluids.
ANS: A
The T type of lymphocyte responds to antigens presented by other cells in the context of
major histocompatibility complex (MHC) proteins.
DIF: Cognitive Level: I
17. Cytokines
a. are produced by various cells of the immune system including lymphocytes,
monocytes, macrophages.
b. act on various elements of the immune system.
c. are molecular structures.
d. All of the above.
ANS: D
Lymphocytes are immunologically active through various types of direct cell-to-cell contact
and by the production of soluble factors. Nonspecific soluble factors are made by, or act on,
various elements of the immune system. These molecules are collectively called cytokines.
DIF: Cognitive Level: I
18. Another name for Toll-like receptors is
a. genome.
b. pathogen-associated molecular patterns (PAMPs).
c. pattern-recognition receptors.
d. complement.
ANS: C
The number of genes encoded in an organism is called its genome. The innate immune
response may not be able to recognize every possible antigen, but rather may focus on a few
large groups of microorganisms, called pathogen-associated molecular patterns (PAMPs). The
receptors of the innate immune system that recognize these PAMPs are called pattern
recognition receptors (e.g., Toll-like receptors).
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DIF: Cognitive Level: I
19. The innate immune system is
a. the most ancient form of host defense.
b. divided into two components, each with a different function.
c. mediated by germline-encoded receptors.
d. Both A and C.
ANS: D
The innate immune system is an ancient form of host defense that appeared before the
adaptive immune system. Some form of innate immunity probably exists in all multicellular
organisms. Innate immune recognition is mediated by germline-encoded receptors, which
means that the specificity of each receptor is genetically predetermined. Germline-encoded
receptors evolved by natural selection to have defined specificities for infectious
microorganisms.
DIF: Cognitive Level: II
20. Mechanisms of innate immunity
a. are activated immediately after infection.
b. quickly begin to control multiplication.
c. are organized around T and B lymphocytes.
d. Both A and B.
ANS: D
Mechanisms of innate immunity (e.g., phagocytes) and the alternate complement pathways
are activated immediately after infection and quickly begin to control the multiplication of
infecting microorganisms.
DIF: Cognitive Level: II
21. A specific component of the adaptive immune system formed in response to antigenic
stimulation is
a. complement.
b. immunoglobulin.
c. increased secretion of mucus.
d. enhanced phagocytosis.
ANS: B
If specific antibodies have been formed to antigenic stimulation, they are available to protect
the body against foreign substances. The recognition of foreign substances and subsequent
production of antibodies to these substances defines immunity.
DIF: Cognitive Level: I
22. Acquired immunity can result from
a. vaccination by injection of an antigen.
b. contracting a disease.
c. genetic inheritance.
d. Both A and B.
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ANS: D
Antibody-mediated immunity to infection can be acquired if the antibodies are formed by the
host or if they are received from another source; these two types of acquired immunity are
called active immunity and passive immunity, respectively.
DIF: Cognitive Level: I
23. A child who contracts a contagious disease from an older sibling could develop a form of
immunity against the disease due to the mechanism of:
a. natural active
b. artificial active
c. natural passive
d. artificial passive
ANS: A
Active immunity can be acquired by natural exposure in response to an infection or natural
series of infections, or through intentional injection of an antigen.
DIF: Cognitive Level: II
24. Preschool children who are vaccinated against specific microorganisms would be expected to
develop a form of immunity against those microorganisms due to the immune mechanism of:
a. natural active
b. artificial active
c. natural passive
d. artificial passive
ANS: B
Vaccination is an effective artificial method of stimulating antibody production and memory
(acquired resistance) without contracting the disease.
DIF: Cognitive Level: I
25. Artificial passive immunity is achieved by
a. vaccination.
b. contracting a disease.
c. infusion or injection of preformed specific antibody.
d. transfer in vivo.
ANS: C
Artificial passive immunity is achieved by infusion of serum or plasma containing high
concentrations of antibody or lymphocytes from an actively immunized individual. Passive
immunity via preformed antibodies in serum provides immediate, temporary antibody
protection against microorganisms (e.g., hepatitis A) by administering preformed antibodies.
DIF: Cognitive Level: I
26. In the first line of nonspecific body defense, intact skin, is cut with a piece of glass
contaminated with Staphylococcus aureus, which cellular component of the immune system
quickly responds?
a. T lymphocytes
b. B lymphocytes
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Test Bank - Immunology and Serology in Laboratory Medicine, 7th Edition (Turgeon, 2022)
c. Neutrophils
d. Platelets
ANS: C
The neutrophilic leukocyte, particularly the polymorphonuclear neutrophil (PMN) type,
provides an effective host defense against bacterial and fungal infections.
DIF: Cognitive Level: II
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