18 Test Bank

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
Bloom's Taxonomy: Knowledge
ASMcue Outcome: 6.3
Learning Outcome: 18.3
2) Patient's 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
Bloom's Taxonomy: Analysis
ASMcue Outcome: 6.3
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
Bloom's Taxonomy: Comprehension
Global Outcome: 2
1
Copyright © 2016 Pearson Education, Ltd.
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
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
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
2
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
8) A reaction between antibody and particulate antigen is called a(n)

Answer: A
Section: 18.2
9) A reaction that uses the absence of hemolysis of red blood cells to indicate an antigen—
antibody reaction is called a(n)
Answer: B
Section: 18.2
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
ASMcue Outcome: 4.4
3
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
12) The clumping of test red blood cells indicates a negative test result (no antibodies against the
virus in the patient's 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
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
ASMcue Outcome: 4.4
14) Purified protein from Bordetella pertussis is used in a(n)

A) conjugated vaccine.
B) subunit vaccine.
D) attenuated whole-agent vaccine.
E) toxoid vaccine.
Answer: B
Section: 18.1
ASMcue Outcome: 6.3
Global Outcome: 5
4
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
ASMcue Outcome: 6.3
Global Outcome: 5
16) A test used to identify antibodies against Treponema pallidum in a patient's 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
17) A test used to identify Streptococcus pyogenes in a patient's throat swab is the
C) hemagglutination test.
D) hemagglutination-inhibition test.
E) indirect ELISA test.
Answer: A
Section: 18.2
18) A test used to detect anti-Rickettsia antibodies in a patient's serum is the

Answer: B
Section: 18.2
Global Outcome: 2
5
19) Which of the following is a pregnancy test used to find the fetal hormone HCG in a woman's
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
Global Outcome: 2
20) Which of the following is a test to determine a patient's blood type by mixing the patient's
red blood cells with antisera?
B) passive agglutination reaction
Answer: A
Section: 18.2
Global Outcome: 2
21) Which of the following is a test to determine the presence of soluble antigens in a patient's
saliva?
B) passive agglutination reaction
Answer: E
Section: 18.2
Global Outcome: 2
6
22) A patient's 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
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)
B) subunit vaccine.
D) inactivated whole-agent vaccine.
E) toxoid vaccine.
Answer: B
Section: 18.1
ASMcue Outcome: 4.4
Global Outcome: 2
24) Inactivated tetanus toxin is a(n)

B) subunit vaccine.
D) inactivated whole-agent vaccine.
E) toxoid vaccine.
Answer: E
Section: 18.1
ASMcue Outcome: 6.3
7
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
Table 18.1
Antibody Titer
Day 1 Day 7Day 14Day 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
ASMcue Outcome: 7.1b
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
Global Outcome: 3
8
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
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
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
9
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
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
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
ASMcue Outcome: 3.4
Global Outcome: 5
10
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
ASMcue Outcome: 6.3
Global Outcome: 5
35) Haemophilus capsule polysaccharide plus diphtheria toxoid is a(n)

D) subunit vaccine.
E) toxoid vaccine.
Answer: C
Section: 18.1
ASMcue Outcome: 6.3
Global Outcome: 2
36) Dead Bordetella pertussis can be used in a(n)

D) subunit vaccine.
E) toxoid vaccine.
Answer: A
Section: 18.1
ASMcue Outcome: 6.3
Global Outcome: 2
11
37) Isolated and purified hepatitis B virus surface antigen can be used in a(n)
D) subunit vaccine.
E) toxoid vaccine.
Answer: D
Section: 18.1
ASMcue Outcome: 6.3
Global Outcome: 2
38) In a direct ELISA test to screen for drugs in a patient's 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 patient's urine sample is diluted
D) antibody against the drug being tested is added
Answer: B
Section: 18.2
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
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
Global Outcome: 2
12
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
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
ASMcue Outcome: 6.3
Global Outcome: 2
43) In an immunodiffusion test to diagnose the fungal disease histoplasmosis, a patient's 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
13
44) In an immunodiffusion test to diagnose histoplasmosis, a patient's 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
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
ASMcue Outcome: 5.4
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
ASMcue Outcome: 6.3
Global Outcome: 5
2) In a vaccine preparation, the term "attenuated" means that the agent does NOT replicate.
Answer: FALSE
Section: 18.1
ASMcue Outcome: 3.4
14
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
ASMcue Outcome: 3.4
4) Adjuvants such as aluminum salts are used as additives in vaccines to enhance immune
responses.
Answer: TRUE
Section: 18.1
ASMcue Outcome: 3.4
Global Outcome: 5
5) Blood typing tests are examples of hemagglutination reactions.

Answer: TRUE
Section: 18.2
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
Global Outcome: 2
7) The home pregnancy test kit is an example of a direct ELISA.

Answer: TRUE
Section: 18.2
Global Outcome: 5
8) Western blotting uses antibodies to detect specific proteins in a mixture of proteins.

Answer: TRUE
Section: 18.2
15
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
Global Outcome: 2
10) Agglutination tests use particulate antigens while precipitation tests use soluble antigens.
Answer: TRUE
Section: 18.2
18.3 Essay Questions
1) Describe an ELISA test to detect the presence of HIV antibodies in a patient.

Section: 18.2
Bloom's Taxonomy: Application
ASMcue Outcome: 8.3
Global Outcome: 8
2) Design a serological test to detect botulinum toxin in food.

Section: 18.2
Bloom's Taxonomy: Synthesis
ASMcue Outcome: 7.4
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
Bloom's Taxonomy: Synthesis
ASMcue Outcome: 7.4
Global Outcome: 8
16

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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

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

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

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

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

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

24) Inactivated tetanus toxin is a(n)

Day 1 Day 7Day 14Day 21

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

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

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

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

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

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

18.2 True/False Questions

5) Blood typing tests are examples of hemagglutination reactions.

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

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

18.3 Essay Questions

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

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

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