Chapter 18 Practical Applications of Immunology My Nursing Test Banks

Microbiology: An Introduction, 12e, (Tortora)

Chapter 18   Practical Applications of Immunology

18.1   Multiple-Choice Questions

1) All of the following are generally used in vaccines EXCEPT

A) toxoids.

B) parts of bacterial cells.

C) live, attenuated viruses.

D) inactivated viruses.

E) antibodies.

Answer:  E

Section:  18.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  6.3

Learning Outcome:  18.3

2) Patients serum, influenza virus, and red blood cells are mixed in a tube. What happens if the patient has antibodies against influenza virus?

A) agglutination

B) hemagglutination

C) complement fixation

D) hemolysis

E) hemagglutination-inhibition

Answer:  E

Section:  18.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  6.3

Learning Outcome:  18.14

Global Outcome:  2

3) A patient shows the presence of antibodies against diphtheria toxin. Which of the following statements is FALSE?

A) The patient may have the disease.

B) The patient may have had the disease and has recovered.

C) The patient may have been vaccinated.

D) A recent transfusion may have passively introduced the antibodies.

E) The patient was near someone who had the disease.

Answer:  E

Section:  18.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.4

Global Outcome:  2

4) In an agglutination test, eight serial dilutions to determine antibody titer were set up. Tube #1 contained a 1:2 dilution; tube #2, a 1:4, etc. If tube #6 is the last tube showing agglutination, what is the antibody titer?

A) 6

B) 1:6

C) 64

D) 1:32

E) 32

Answer:  C

Section:  18.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.11

Global Outcome:  4

5) An ELISA for Hepatitis C has 95 percent sensitivity and 90 percent specificity. This means that the test

A) detects 95 percent of the true positive samples and has 10 percent false positive results.

B) detects 5 percent of the true positive samples and has 90 percent false positive results.

C) detects 90 percent of the true positive samples and has 5 percent false positive results.

D) detects 95 percent of the true positive samples and has 90 percent false positive results.

E) detects 5 percent of the true positive samples and has 10 percent false positive results.

Answer:  A

Section:  18.2

Blooms Taxonomy:  Analysis

Learning Outcome:  18.8

Global Outcome:  2

6) Which of the following are sources of antibodies for serological testing?

A) vaccinated animals

B) cells producing monoclonal antibodies

C) viral cultures

D) vaccinated animals and cells producing monoclonal antibodies

E) vaccinated animals, cells producing monoclonal antibodies, and viral cultures

Answer:  D

Section:  18.2

Blooms Taxonomy:  Analysis

Learning Outcome:  18.9

7) A reaction between an antibody and soluble antigen-forming lattices is called a(n)

A) agglutination reaction.

B) complement fixation.

C) immunofluorescence.

D) neutralization reaction.

E) precipitation reaction.

Answer:  E

Section:  18.2

Blooms Taxonomy:  Knowledge

Learning Outcome:  18.10

8) A reaction between antibody and particulate antigen is called a(n)

A) agglutination reaction.

B) complement fixation.

C) immunofluorescence.

D) neutralization reaction.

E) precipitation reaction.

Answer:  A

Section:  18.2

Blooms Taxonomy:  Knowledge

Learning Outcome:  18.12

9) A reaction that uses the absence of hemolysis of red blood cells to indicate an antigenantibody reaction is called a(n)

A) agglutination reaction.

B) complement fixation.

C) immunofluorescence.

D) neutralization reaction.

E) precipitation reaction.

Answer:  B

Section:  18.2

Blooms Taxonomy:  Knowledge

Learning Outcome:  18.16

10) A DNA plasmid encoding a protein antigen from West Nile virus is injected into muscle cells of a horse. This is an example of a(n)

A) subunit vaccine.

B) conjugated vaccine.

C) nucleic acid vaccine.

D) attenuated whole-agent vaccine.

E) live whole-agent vaccine.

Answer:  C

Section:  18.1

Blooms Taxonomy:  Analysis

ASMcue Outcome:  4.4

Learning Outcome:  18.4

11) Toxoid vaccines, such as the vaccines against diphtheria and tetanus, elicit a(n)

A) TC cell response.

B) immune complex.

C) dendritic cell proliferation.

D) antibody response against these bacterial toxins.

E) antibody response against gram-positive bacteria.

Answer:  D

Section:  18.1

Blooms Taxonomy:  Analysis

Learning Outcome:  18.3

12) The clumping of test red blood cells indicates a negative test result (no antibodies against the virus in the patients serum) in the

A) direct agglutination test.

B) indirect agglutination test.

C) complement-fixation test.

D) precipitation test.

E) viral hemagglutination inhibition test.

Answer:  E

Section:  18.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.14

13) What type of vaccine involves host synthesis of viral antigens?

A) conjugated vaccine

B) subunit vaccine

C) nucleic acid vaccine

D) attenuated whole-agent vaccine

E) toxoid vaccine

Answer:  C

Section:  18.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  4.4

Learning Outcome:  18.4

14) Purified protein from Bordetella pertussis is used in a(n)

A) conjugated vaccine.

B) subunit vaccine.

C) nucleic acid vaccine.

D) attenuated whole-agent vaccine.

E) toxoid vaccine.

Answer:  B

Section:  18.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  6.3

Learning Outcome:  18.4

Global Outcome:  5

15) What type of vaccine is the live, weakened measles virus?

A) conjugated vaccine

B) subunit vaccine

C) nucleic acid vaccine

D) attenuated whole-agent vaccine

E) toxoid vaccine

Answer:  D

Section:  18.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  6.3

Learning Outcome:  18.3

Global Outcome:  5

16) A test used to identify antibodies against Treponema pallidum in a patients serum is the

A) direct fluorescent-antibody test.

B) indirect fluorescent-antibody test.

C) direct agglutination test.

D) direct ELISA test.

E) hemagglutination-inhibition test.

Answer:  B

Section:  18.2

Blooms Taxonomy:  Knowledge

Learning Outcome:  18.17

17) A test used to identify Streptococcus pyogenes in a patients throat swab is the

A) direct fluorescent-antibody test.

B) indirect fluorescent-antibody test.

C) hemagglutination test.

D) hemagglutination-inhibition test.

E) indirect ELISA test.

Answer:  A

Section:  18.2

Blooms Taxonomy:  Knowledge

Learning Outcome:  18.17

18) A test used to detect anti-Rickettsia antibodies in a patients serum is the

A) direct fluorescent-antibody test.

B) indirect fluorescent-antibody test.

Answer:  B

Section:  18.2

Blooms Taxonomy:  Analysis

Learning Outcome:  18.17

Global Outcome:  2

19) Which of the following is a pregnancy test used to find the fetal hormone HCG in a womans urine using anti-HCG and latex spheres?

A) direct agglutination reaction

B) indirect agglutination reaction

C) immunofluorescence

D) neutralization reaction

E) precipitation reaction

Answer:  B

Section:  18.2

Blooms Taxonomy:  Analysis

Learning Outcome:  18.11

Global Outcome:  2

20) Which of the following is a test to determine a patients blood type by mixing the patients red blood cells with antisera?

A) direct agglutination reaction

B) passive agglutination reaction

C) immunofluorescence

D) neutralization reaction

E) precipitation reaction

Answer:  A

Section:  18.2

Blooms Taxonomy:  Analysis

Learning Outcome:  18.11

Global Outcome:  2

21) Which of the following is a test to determine the presence of soluble antigens in a patients saliva?

A) direct agglutination reaction

B) passive agglutination reaction

C) immunofluorescence

D) neutralization reaction

E) precipitation reaction

Answer:  E

Section:  18.2

Blooms Taxonomy:  Analysis

Learning Outcome:  18.10

Global Outcome:  2

22) A patients serum, Mycobacterium, guinea pig complement, sheep red blood cells, and anti-sheep red blood cell antibodies are mixed in a test tube. What happens if the patient has antibodies to Mycobacterium?

A) Bacteria fluoresce.

B) Hemagglutination occurs.

C) Hemagglutination-inhibition occurs.

D) Hemolysis occurs.

E) No hemolysis occurs.

Answer:  E

Section:  18.2

Blooms Taxonomy:  Analysis

Learning Outcome:  18.16

Global Outcome:  2

23) A vaccine against HIV proteins made by a genetically-engineered vaccinia virus that has infected a eukaryotic cell line is a(n)

A) conjugated vaccine.

B) subunit vaccine.

C) nucleic acid vaccine.

D) inactivated whole-agent vaccine.

E) toxoid vaccine.

Answer:  B

Section:  18.1

Blooms Taxonomy:  Analysis

ASMcue Outcome:  4.4

Learning Outcome:  18.3

Global Outcome:  2

24) Inactivated tetanus toxin is a(n)

A) conjugated vaccine.

B) subunit vaccine.

C) nucleic acid vaccine.

D) inactivated whole-agent vaccine.

E) toxoid vaccine.

Answer:  E

Section:  18.1

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  6.3

Learning Outcome:  18.3

25) A hybridoma results from the fusion of a(an)

A) B cell with a T cell.

B) B cell with a myeloma cell.

C) antigen with an antibody.

D) antigen with a B cell.

E) myeloma cell with a virus.

Answer:  B

Section:  18.2

Blooms Taxonomy:  Knowledge

Learning Outcome:  18.9

Table 18.1

Antibody Titer

Day 1

Day 7

Day 14

Day 21

Patient A

0

0

256

512

Patient B

128

256

512

1024

Patient C

0

0

0

0

Patient D

128

128

128

128

26) In Table 18.1, who probably has the disease?

A) Patients A and B

B) Patients B and C

C) Patients A and C

D) Patients C and D

E) Patients A and D

Answer:  A

Section:  18.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  7.1b

Learning Outcome:  18.11

Global Outcome:  3

27) In Table 18.1, who is most likely protected from the disease, as observed by the test results over time?

A) Patient A

B) Patient B

C) Patient C

D) Patient D

Answer:  D

Section:  18.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  7.1b

Learning Outcome:  18.11

Global Outcome:  3

28) In Table 18.1, who showed seroconversion during these observations?

A) Patient A

B) Patient B

C) Patient C

D) Patient D

Answer:  A

Section:  18.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  7.1b

Learning Outcome:  18.11

Global Outcome:  3

Figure 18.1

29) Which component in Figure 18.1 came from the patient in this indirect ELISA test?

A) a

B) b

C) c

D) d

E) e

Answer:  B

Section:  18.2

Blooms Taxonomy:  Analysis

Learning Outcome:  18.18

Global Outcome:  3

30) Figure 18.1 is an illustration of a(an)

A) negative indirect ELISA test.

B) positive indirect ELISA test.

C) complement fixation test.

D) hemagglutination test.

E) precipitation test.

Answer:  B

Section:  18.2

Blooms Taxonomy:  Analysis

Learning Outcome:  18.18

31) Monoclonal antibodies are used in diagnostic tests and disease treatments because they

A) are highly specific.

B) can be produced in large quantities.

C) contain a mixture of antibodies.

D) are highly specific and they can be produced in large quantities.

E) are highly specific, they can be produced in large quantities, and they contain a mixture of antibodies.

Answer:  D

Section:  18.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.20

32) The following steps are used to produce monoclonal antibodies. What is the fourth step?

A) A B cell is activated to produce antibodies.

B) Culture the hybridoma in a selective medium.

C) Fuse a B cell to a myeloma cell.

D) Isolate antibody-producing B cells.

E) Vaccinate a mouse.

Answer:  C

Section:  18.2

Blooms Taxonomy:  Analysis

Learning Outcome:  18.20

33) Palivizumab is used to treat respiratory syncytial virus disease. This antiviral drug is a(n)

A) toxoid.

B) monoclonal antibody.

C) vaccine.

D) immunosuppressive.

E) nucleoside analog.

Answer:  B

Section:  18.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  3.4

Learning Outcome:  18.20

Global Outcome:  5

34) Live weakened polio virus can be used directly in a(n)

A) inactivated whole-agent vaccine.

B) attenuated whole-agent vaccine.

C) conjugated vaccine.

D) subunit vaccine.

E) toxoid vaccine.

Answer:  B

Section:  18.1

Blooms Taxonomy:  Analysis

ASMcue Outcome:  6.3

Learning Outcome:  18.3

Global Outcome:  5

35) Haemophilus capsule polysaccharide plus diphtheria toxoid is a(n)

A) inactivated whole-agent vaccine.

B) attenuated whole-agent vaccine.

C) conjugated vaccine.

D) subunit vaccine.

E) toxoid vaccine.

Answer:  C

Section:  18.1

Blooms Taxonomy:  Analysis

ASMcue Outcome:  6.3

Learning Outcome:  18.3

Global Outcome:  2

36) Dead Bordetella pertussis can be used in a(n)

A) inactivated whole-agent vaccine.

B) attenuated whole-agent vaccine.

C) conjugated vaccine.

D) subunit vaccine.

E) toxoid vaccine.

Answer:  A

Section:  18.1

Blooms Taxonomy:  Analysis

ASMcue Outcome:  6.3

Learning Outcome:  18.3

Global Outcome:  2

37) Isolated and purified hepatitis B virus surface antigen can be used in a(n)

A) inactivated whole-agent vaccine.

B) attenuated whole-agent vaccine.

C) conjugated vaccine.

D) subunit vaccine.

E) toxoid vaccine.

Answer:  D

Section:  18.1

Blooms Taxonomy:  Analysis

ASMcue Outcome:  6.3

Learning Outcome:  18.3

Global Outcome:  2

38) In a direct ELISA test to screen for drugs in a patients urine, what is the third step in the test process?

A) substrate for the enzyme is added

B) enzyme-labeled antibodies against the drug being tested is added

C) the patients urine sample is diluted

D) antibody against the drug being tested is added

Answer:  B

Section:  18.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.18

39) Which item is from the patient in a direct ELISA test?

A) substrate for the enzyme

B) antigen

C) antihuman immune serum

D) antibodies against the antigen

Answer:  B

Section:  18.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.18

40) Which of the following tests is MOST useful in determining the presence of AIDS antibodies?

A) agglutination

B) complement fixation

C) neutralization

D) indirect ELISA

E) direct fluorescent-antibody

Answer:  D

Section:  18.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.18

Global Outcome:  2

41) Which of the following uses fluorescent-labeled antibodies?

A) agglutination

B) complement fixation

C) precipitation

D) flow cytometry

E) neutralization

Answer:  D

Section:  18.2

Blooms Taxonomy:  Knowledge

Learning Outcome:  18.17

42) Which of the following is NOT an advantage of live attenuated vaccine agents?

A) They elicit lifelong immunity.

B) They stimulate by cell-mediated and humoral immune responses.

C) They occasionally revert to virulent forms.

D) They require few or no booster immunizations.

E) The immune response generated by the vaccine closely mimics a real infection.

Answer:  C

Section:  18.1

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  6.3

Learning Outcome:  18.7

Global Outcome:  2

43) In an immunodiffusion test to diagnose the fungal disease histoplasmosis, a patients serum is placed in a well in an agar plate. In a positive test, a precipitate forms as the serum diffuses from the well and meets material diffusing from a second well. In this test process, what is the most likely identity of the material in the second well?

A) antibodies

B) a purified fungal antigen

C) entire fungal cells

D) a purified protozoan antigen

E) red blood cells

Answer:  B

Section:  18.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.10

44) In an immunodiffusion test to diagnose histoplasmosis, a patients serum is placed in a well in an agar plate. In a positive test, a line forms as the serum diffuses from the well and meets material diffusing from a second well. What type of test is this?

A) an agglutination reaction

B) a precipitation reaction

C) a complement-fixation test

D) an indirect ELISA test

E) a direct ELISA test

Answer:  B

Section:  18.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.10

45) Which of the following statements about measles is FALSE?

A) It is a serious disease.

B) It is preventable by vaccination.

C) Annually, it kills thousands of children worldwide.

D) The disease has been eradicated in the United States.

E) Complications include pneumonia, encephalitis, and death.

Answer:  D

Section:  18.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  18.7

18.2   True/False Questions

1) Vaccines are preparations of organisms or fractions of organisms that are used to induce protective immune responses.

Answer:  TRUE

Section:  18.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  6.3

Learning Outcome:  18.1

Global Outcome:  5

2) In a vaccine preparation, the term attenuated means that the agent does NOT replicate.

Answer:  FALSE

Section:  18.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  3.4

Learning Outcome:  18.3

3) An injection of naked DNA into muscle cells to induce an immune response against the proteins encoded by the DNA is an example of a subunit vaccine.

Answer:  FALSE

Section:  18.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  3.4

Learning Outcome:  18.4

4) Adjuvants such as aluminum salts are used as additives in vaccines to enhance immune responses.

Answer:  TRUE

Section:  18.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  3.4

Learning Outcome:  18.6

Global Outcome:  5

5) Blood typing tests are examples of hemagglutination reactions.

Answer:  TRUE

Section:  18.2

Blooms Taxonomy:  Knowledge

Learning Outcome:  18.13

Global Outcome:  5

6) A positive complement-fixation test is indicated by the lysis of the sheep red blood cells added in the indicator phase of the test.

Answer:  FALSE

Section:  18.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.16

Global Outcome:  2

7) The home pregnancy test kit is an example of a direct ELISA.

Answer:  TRUE

Section:  18.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.18

Global Outcome:  5

8) Western blotting uses antibodies to detect specific proteins in a mixture of proteins.

Answer:  TRUE

Section:  18.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.19

9) A highly specific diagnostic test will be unlikely to indicate a positive result if a specimen being tested is a true negative.

Answer:  TRUE

Section:  18.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  18.8

Global Outcome:  2

10) Agglutination tests use particulate antigens while precipitation tests use soluble antigens.

Answer:  TRUE

Section:  18.2

Blooms Taxonomy:  Knowledge

Learning Outcome:  18.12

18.3   Essay Questions

1) Describe an ELISA test to detect the presence of HIV antibodies in a patient.

Section:  18.2

Blooms Taxonomy:  Application

ASMcue Outcome:  8.3

Learning Outcome:  18.18

Global Outcome:  8

2) Design a serological test to detect botulinum toxin in food.

Section:  18.2

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  7.4

Learning Outcome:  18.9

Global Outcome:  8

3) In your work in a county public health clinic, you encounter parents of a three-month-old who are considering not vaccinating their child. What concerns might the parents raise regarding vaccine safety? As a microbiology student and public health care worker, what do you say to these parents regarding the risks of not vaccinating their child?

Section:  18.1

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  7.4

Learning Outcome:  18.7

Global Outcome:  8

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