3.
1 MCQ’s: IntroductiontoSerology
Question 1: What is the primary focus of serology?
(A) The study of blood cells
(B) The study of the formed elements of blood
(C) The study of the fluid components in the blood, especially antibodies
(D) The study of blood clotting factors
Answer: (C) The study of the fluid components in the blood, especially antibodies
Question 2: Which blood component must be inactivated because it interferes with test
results in serology?
(A) Red blood cells
(B) White blood cells
(C) Platelets
(D) Complement
Answer: (D) Complement
Question 3: What are two methods mentioned for inactivating the component described in the
previous question?
(A) Heating to 100°C for 15 minutes and adding sodium chloride
(B) Heating to 56°C for 30 minutes and adding choline chloride
(C) Freezing at -80°C and adding EDTA
(D) Centrifugation and filtration
Answer: (B) Heating to 56°C for 30 minutes and adding choline chloride
Question 4: What is the recommended storage temperature for serum samples for up to 72
hours?
(A) -20°C or below
(B) 37°C
(C) 2°C and 8°C
(D) Room temperature
Answer: (C) 2°C and 8°C
Question 5: If more than 4 hours have elapsed since inactivation, how can a specimen be
re-inactivated?
(A) By adding more choline chloride
(B) By heating it to 100°C for 5 minutes
(C) By heating it to 56°C for 10 minutes
(D) By freezing it rapidly
Answer: (C) By heating it to 56°C for 10 minutes
Question 6: Which of the following is a serology application?
(A) Culturing infectious agents
(B) Confirmation of etiologic agent
(C) Measuring blood cell counts
(D) Determining blood type
Answer: (B) Confirmation of etiologic agent
Question 7: What is the general term for tests that involve antigen-antibody reactions?
(A) Serology
(B) Immunoassays/Serologic test
(C) Blood typing
(D) Complete blood count
Answer: (B) Immunoassays/Serologic test
Question 8: In an immunoassay, what is being detected when using known or commercial
anti-sera?
(A) Unknown antibodies in the patient's serum
(B) Unknown antigens in the specimen
(C) Complement activity
(D) Blood cell count
Answer: (B) Unknown antigens in the specimen
Question 9: What is being detected when using known commercial antigen?
(A) Unknown antigens in the specimen
(B) Unknown antibodies in the serum of patient
(C) Complement activity
(D) Blood cell count
Answer: (B) Unknown antibodies in the serum of patient
Question 10: What is another term used to describe the type of immunoassay that detects
unknown antigens using known anti-sera?
(A) Indirect
(B) Reverse
(C) Forward
(D) Agglutination
Answer: (C) Forward
Here's a quiz based on the images, with answers in the requested format:
Quiz on Introduction to Serology (Continued)
Question 11: According to the image, what is involved in immunologic reactions?
(A) Antigen-antibody combination
(B) Antibody-antibody combination
(C) Antigen-antigen combination
(D) Complement-antibody combination
Answer: (A) Antigen-antibody combination
Question 12: Are all antigen-antibody reactions visible?
(A) Yes
(B) No
Answer: (B) No
Question 13: What is detectable in a tertiary immunologic reaction, according to the image?
(A) Non-visible reaction
(B) Visible precipitate
(C) Biologic reaction in vivo
(D) Complement activation
Answer: (C) Biologic reaction in vivo
Question 14: Who first noted precipitation reactions?
(A) Pasteur
(B) Koch
(C) Kraus
(D) Ehrlich
Answer: (C) Kraus
Question 15: What does a precipitation reaction involve?
(A) Combining soluble antigen with soluble antibody to produce insoluble complexes
(B) Combining insoluble antigen with soluble antibody to produce soluble complexes
(C) Combining soluble antigen with insoluble antibody to produce insoluble complexes
(D) Combining insoluble antigen with insoluble antibody to produce soluble complexes
Answer: (A) Combining soluble antigen with soluble antibody to produce insoluble complexes
Question 16: At what point does optimum precipitation occur?
(A) Zone of antibody excess
(B) Zone of antigen excess
(C) Zone of equivalence
(D) Prozone
Answer: (C) Zone of equivalence
Question 17: In the diagram, what is present in higher concentration in the "prozone"?
(A) Antigen
(B) Antibody
(C) Precipitate
(D) Complement
Answer: (B) Antibody
Question 18: In the diagram, what is present in higher concentration in the "post zone"?
(A) Antibody
(B) Antigen
(C) Precipitate
(D) Complement
Answer: (B) Antigen
Question 19: In the diagram, what is present in equal parts in the Zone of Equivalence?
(A) Antigen and Complement
(B) Antibody and Complement
(C) Antigen and Antibody
(D) Precipitate and Complement
Answer: (C) Antigen and Antibody
Question 20: According to the image, where is precipitate visible?
(A) In the prozone only
(B) In the post zone only
(C) Only where precipitate is visible
(D) In both prozone and post zone
Answer: (C) Only where precipitate is visible
Question 21: What does turbidimetry measure?
(A) Light scattered at a particular angle
(B) The turbidity/cloudiness of a solution
(C) The amount of antigen in a solution
(D) The amount of antibody in a solution
Answer: (B) The turbidity/cloudiness of a solution
Question 22: What causes the reduction in light intensity in turbidimetry?
(A) Reflection, absorption, or scatter
(B) Fluorescence
(C) Luminescence
(D) Refraction
Answer: (A) Reflection, absorption, or scatter
Question 23: In what units is the measurement recorded in turbidimetry?
(A) mg/dL
(B) IU/mL
(C) Absorbance unit
(D) Degrees
Answer: (C) Absorbance unit
Question 24: According to the image, what does high turbidity indicate?
(A) Low concentration
(B) High concentration
(C) No concentration
(D) Optimal concentration
Answer: (B) High concentration
Question 25: What does nephelometry measure?
(A) The turbidity/cloudiness of a solution
(B) Light scattered at a particular angle
(C) The reduction in light intensity
(D) Absorbance
Answer: (B) Light scattered at a particular angle
Question 26: What is the amount of light scattered in nephelometry an index of?
(A) The size of the particles
(B) The temperature of the solution
(C) The solution's concentration
(D) The pH of the solution
Answer: (C) The solution's concentration
Question 27: What can light scatter measurements be extrapolated to give?
(A) The size of the particles
(B) The temperature of the solution
(C) Actual concentrations in milligrams per deciliter (mg/dL) or international units per milliliter
(IU/mL)
(D) The pH of the solution
Answer: (C) Actual concentrations in milligrams per deciliter (mg/dL) or international units per
milliliter (IU/mL)
Question 28: What are the two methods of precipitation in a support medium mentioned in the
image?
(A) Turbidimetry and Nephelometry
(B) Immunodiffusion and Electrophoresis
(C) Agglutination and Precipitation
(D) Titration and Dilution
Answer: (B) Immunodiffusion and Electrophoresis
Question 29: What is a characteristic of passive immunodiffusion?
(A) It requires an electric current.
(B) It does not need electric current.
(C) It measures light scattering.
(D) It measures turbidity.
Answer: (B) It does not need electric current.
Question 30: What factors affect the rate of diffusion in passive immunodiffusion?
(A) Electric current and voltage
(B) Size of the particles, temperature, gel viscosity, and amount of hydration
(C) Light intensity and wavelength
(D) pH and salinity
Answer: (B) Size of the particles, temperature, gel viscosity, and amount of hydration
Question 31: What are the advantages of passive immunodiffusion?
(A) Fast and accurate
(B) Simple and cheap
(C) High sensitivity and specificity
(D) Quantitative and precise
Answer: (B) Simple and cheap
Question 32: What is a disadvantage of passive immunodiffusion?
(A) High cost
(B) Long turnaround time
(C) Low sensitivity
(D) Complex procedure
Answer: (B) Long turnaround time
Question 33: In single diffusion, single dimension (Oudin test), which moves, Ag or Ab?
(A) Only Ag
(B) Only Ab
(C) Both Ag and Ab
(D) Neither Ag nor Ab
Answer: (A) Only Ag
Question 34: What is the end result of the Oudin test?
(A) A color change
(B) A precipitin line
(C) A fluorescent signal
(D) A change in pH
Answer: (B) A precipitin line
Question 35: Is the Oudin test quantitative or semi-quantitative?
(A) Quantitative
(B) Semi-quantitative
Answer: (B) Semi-quantitative
Question 36: In Single Diffusion, Double Dimension, what is uniformly distributed in the
support gel?
(A) Antigen
(B) Antibody
(C) Precipitate
(D) Buffer
Answer: (B) Antibody
Question 37: In Single Diffusion, Double Dimension, what is applied to a well cut into the gel?
(A) Antibody
(B) Antigen
(C) Precipitate
(D) Buffer
Answer: (B) Antigen
Question 38: What is the end result of Single Diffusion, Double Dimension?
(A) A color change
(B) A precipitin ring
(C) A fluorescent signal
(D) A change in pH
Answer: (B) A precipitin ring
Question 39: What is the relationship between the diameter of the precipitin ring and the
antigen concentration in Single Diffusion, Double Dimension?
(A) Inversely proportional
(B) Directly proportional
(C) No relationship
(D) Exponentially proportional
Answer: (B) Directly proportional
Question 40: What does the Fahey and McKelvey method measure?
(A) Endpoint diffusion
(B) Kinetic diffusion
(C) Light scattering
(D) Turbidity
Answer: (B) Kinetic diffusion
Question 41: What does the Mancini method measure?
(A) Rate of diffusion
(B) Endpoint diffusion
(C) Light scattering
(D) Turbidity
Answer: (B) Endpoint diffusion
Question 42: In the Mancini method, what is proportional to the concentration?
(A) Diameter of the ring
(B) Square of the diameter
(C) Log of the diameter
(D) Absorbance
Answer: (B) Square of the diameter
Question 43: In Double Diffusion, Double Dimension (Ouchterlony technique), how do antigen
and antibody diffuse?
(A) Only horizontally
(B) Only vertically
(C) Independently through a semi-solid medium in two dimensions
(D) They do not diffuse
Answer: (C) Independently through a semi-solid medium in two dimensions
Question 44: In the Ouchterlony technique, where is the multispecific antibody placed?
(A) In the surrounding wells
(B) In the central well
(C) On the edge of the gel
(D) Mixed with the antigen
Answer: (B) In the central well
Question 45: What are placed in the surrounding wells in the Ouchterlony technique?
(A) More antibody
(B) Different antigens
(C) Buffer solution
(D) Precipitate
Answer: (B) Different antigens
Question 46: What type of test is the Ouchterlony technique?
(A) Quantitative
(B) Semi-quantitative
(C) Qualitative
(D) Colorimetric
Answer: (C) Qualitative
Question 47: What does "Arc Formation" in the Ouchterlony technique indicate?
(A) Non-identity
(B) Partial identity
(C) Serological identity
(D) Different concentrations
Answer: (C) Serological identity
Question 48: What do "Crossed Lines" in the Ouchterlony technique indicate?
(A) Serological identity
(B) Partial identity
(C) Non-identity
(D) Same concentration
Answer: (C) Non-identity
Question 49: What does "Spur Formation" in the Ouchterlony technique indicate?
(A) Serological identity
(B) Partial identity
(C) Non-identity
(D) Different concentrations
Answer: (B) Partial identity
Question 50: What is electrophoresis?
(A) A technique which separates molecules using light
(B) A technique which separates molecules using electrical current
(C) A technique which separates molecules using magnetism
(D) A technique which separates molecules using gravity
Answer: (B) A technique which separates molecules using electrical current
Question 51: In electrophoretic techniques, what is forced through the gel?
(A) Light
(B) A direct current
(C) A magnetic field
(D) A vacuum
Answer: (B) A direct current
Question 52: What is formed as diffusion takes place in electrophoretic techniques?
(A) A color change
(B) Distinct Precipitin Bands
(C) A fluorescent signal
(D) A change in pH
Answer: (B) Distinct Precipitin Bands
Question 53: What is Rocket Electrophoresis also known as?
(A) Ouchterlony technique
(B) Laurell Technique
(C) Mancini method
(D) Turbidimetry
Answer: (B) Laurell Technique
Question 54: What two techniques does Rocket Electrophoresis combine?
(A) Turbidimetry and Nephelometry
(B) RID and electrophoresis
(C) Agglutination and Precipitation
(D) Titration and Dilution
Answer: (B) RID and electrophoresis
Question 55: In Rocket Electrophoresis, what is directly proportional to antigen concentration?
(A) Antibody concentration
(B) The total distance of antigen migration and precipitation
(C) The electric current
(D) The pH of the gel
Answer: (B) The total distance of antigen migration and precipitation
Question 56: In Rocket Electrophoresis, a higher peak indicates what?
(A) Lower concentration
(B) Higher concentration
(C) No concentration
(D) Optimal concentration
Answer: (B) Higher concentration
Question 57: What is a disadvantage of Rocket Electrophoresis?
(A) Long turnaround time
(B) Harder to interpret
(C) Low sensitivity
(D) High cost
Answer: (B) Harder to interpret
Question 58: What two techniques does Immunoelectrophoresis (IEP) combine?
(A) Turbidimetry and Nephelometry
(B) Double diffusion and electrophoresis
(C) Agglutination and Precipitation
(D) Titration and Dilution
Answer: (B) Double diffusion and electrophoresis
Question 59: In Immunoelectrophoresis (IEP), what is electrophoresed to separate out the
main proteins?
(A) Antigen
(B) Serum
(C) Buffer
(D) Gel
Answer: (B) Serum
Question 60: In Immunoelectrophoresis (IEP), what is cut in the gel parallel to the line of
separation?
(A) A well
(B) A trough
(C) A slit
(D) A circle
Answer: (B) A trough
Question 61: What is Immunoelectrophoresis (IEP) useful for?
(A) Measuring enzyme activity
(B) Identifying monoclonal proteins
(C) Counting blood cells
(D) Determining blood type
Answer: (B) Identifying monoclonal proteins
Here's a quiz based on the image, with answers:
Immunofixation Electrophoresis (IFE)
Question 1:
In Immunofixation Electrophoresis (IFE), what is applied directly to the gel's surface?
(A) Antigen
(B) Antisera
(C) Buffer solution
(D) Electric current
Answer: (B) Antisera
Question 2:
Compared to Immunoelectrophoresis (IEP), how does IFE's sensitivity generally compare?
(A) Less sensitive
(B) More sensitive
(C) Equal sensitivity
(D) Sensitivity is not a factor
Answer: (B) More sensitive
Question 3:
IFE is particularly useful for identifying what?
(A) Polyclonal antibodies
(B) Monoclonal protein
(C) Antigens
(D) Enzyme activity
Answer: (B) Monoclonal protein
Question 4:
What sample type is typically used in the IFE procedure described?
(A) Urine
(B) Serum
(C) Tissue
(D) CSF
Answer: (B) Serum
Question 5:
In IFE, what does a dark and narrow band in a specific lane indicate?
(A) Hypogammaglobulinemia
(B) Polyclonal hypergammaglobulinemia
(C) Presence of a monoclonal antibody
(D) Normal protein levels
Answer: (C) Presence of a monoclonal antibody
Counter Immunoelectrophoresis (CIE)
Question 6:
In Counter Immunoelectrophoresis (CIE), where are the antigen and antibody placed in
relation to each other?
(A) In the same well
(B) On the gel's surface
(C) In wells directly opposite each other
(D) At right angles to each other
Answer: (C) In wells directly opposite each other
Question 7:
In CIE, which direction does the antibody migrate?
(A) To the anode
(B) To the cathode
(C) Remains stationary
(D) Depends on the antigen
Answer: (B) To the cathode
Question 8:
What is formed where the antigen and antibody meet in CIE?
(A) A bubble
(B) A precipitate line
(C) An electric field
(D) A color change
Answer: (B) A precipitate line
Question 9:
CIE is particularly useful for the rapid detection of what?
(A) Monoclonal antibodies
(B) Bacterial antigens
(C) Serum proteins
(D) Enzyme deficiencies
Answer: (B) Bacterial antigens
Question 10:
In the CIE diagram, what does "Ag" represent?
(A) Agarose
(B) Antibody
(C) Antigen
(D) Electric current
Answer: (C) Antigen
Question 11:
Who first noted the agglutination reaction?
(A) Pasteur and Koch
(B) Gruber and Durham
(C) Ehrlich and Metchnikoff
(D) Landsteiner and Wiener
Answer: (B) Gruber and Durham
Question 12:
What is the term for antibodies that cause agglutination?
(A) Aggregators
(B) Agglutinins
(C) Precipitins
(D) Opsonins
Answer: (B) Agglutinins
Question 13:
Agglutination is described as a two-step process. What are the two steps?
(A) Precipitation and flocculation
(B) Sensitization and lattice formation
(C) Oxidation and reduction
(D) Activation and inhibition
Answer: (B) Sensitization and lattice formation
Types of Agglutination Reactions
Question 14:
In which type of agglutination reaction are antigens found naturally on the surface of
particles?
(A) Passive agglutination
(B) Reverse passive agglutination
(C) Direct agglutination
(D) Co-agglutination
Answer: (C) Direct agglutination
Question 15:
Which of the following is an example of a direct agglutination test?
(A) ELISA
(B) Western blot
(C) Blood typing
(D) Immunofluorescence
Answer: (C) Blood typing
Question 16:
In passive agglutination, how are antigens attached?
(A) They are naturally present
(B) They are artificially attached to a carrier
(C) They bind directly to antibodies in solution
(D) They are labeled with a fluorescent dye
Answer: (B) They are artificially attached to a carrier
Question 17:
In reverse passive agglutination, what is attached to the particulate carriers?
(A) Antigens
(B) Antibodies
(C) Complement proteins
(D) Enzymes
Answer: (B) Antibodies
Question 18:
Reverse passive agglutination is used to measure levels of which of the following?
(A) Enzymes
(B) Therapeutic drugs
(C) DNA
(D) Lipids
Answer: (B) Therapeutic drugs
Question 19:
Which type of agglutination uses antibodies bound to a particle to enhance the visibility of
agglutination?
(A) Passive agglutination
(B) Reverse passive agglutination
(C) Direct agglutination
(D) Co-agglutination
Answer: (D) Co-agglutination
Question 20:
In agglutination inhibition, what are particulate and soluble antigens competing for?
(A) Enzymes
(B) Antibody combining sites
(C) Complement proteins
(D) Cell receptors
Answer: (B) Antibody combining sites
Question 21:
In agglutination inhibition, what does a lack of agglutination indicate?
(A) A negative reaction
(B) A positive reaction
(C) A false positive
(D) A non-specific binding
Answer: (B) A positive reaction
Question 22:
What is an example of a test that uses agglutination inhibition?
(A) Western Blot
(B) PCR
(C) hCG Test
(D) ELISA
Answer: (C) hCG Test
Question 23:
According to the image, are precipitation and agglutination considered labeled or unlabeled
assays?
(A) Labeled assays
(B) Unlabeled assays
(C) Both labeled and unlabeled
(D) Neither labeled nor unlabeled
Answer: (B) Unlabeled assays
Question 24:
What is a limitation of precipitation and agglutination assays, as mentioned in the image?
(A) High cost
(B) Long reaction time
(C) Relatively low sensitivity
(D) Requirement for specialized equipment
Answer: (C) Relatively low sensitivity
Here's the next part of the quiz, covering Labeled Immunoassays:
General Labeled Immunoassay Concepts
Question 25:
Labeled immunoassays are designed for antigens and antibodies that are present in what kind
of concentrations?
(A) High
(B) Low
(C) Variable
(D) Moderate
Answer: (B) Low
Question 26:
In labeled immunoassays, how is the detection of specific binding achieved?
(A) Direct visualization
(B) Using a labeled reactant
(C) Measuring pH changes
(D) Observing color changes with the naked eye
Answer: (B) Using a labeled reactant
Question 27:
Which of the following is NOT a type of label used in labeled immunoassays, according to the
image?
(A) Radioactive isotopes
(B) Fluorochromes
(C) Enzymes
(D) pH indicators
Answer: (D) pH indicators
Question 28:
What are radioactive isotopes used as labels in?
(A) Immunofluorescence (IF)
(B) Enzyme immunoassay (EIA)
(C) Radioimmunoassay (RIA)
(D) Chemiluminescent assay
Answer: (C) Radioimmunoassay (RIA)
Question 29:
What is another name for Fluorescent Immunoassay?
(A) ELISA
(B) Western Blot
(C) Coon's Test
(D) Southern Blot
Answer: (C) Coon's Test
Question 30:
What are fluorescent compounds used as labels called?
(A) Chromogens
(B) Fluorophores
(C) Radioisotopes
(D) Enzymes
Answer: (B) Fluorophores
Question 31:
What is the most commonly used fluorochrome mentioned in the image?
(A) Rhodamine
(B) Texas Red
(C) Fluorescein isothiocyanate (FITC)
(D) Phycoerythrin
Answer: (C) Fluorescein isothiocyanate (FITC)
Question 32:
What is used to measure the signal in a Fluorescent Immunoassay?
(A) Spectrophotometer
(B) Scintillation counter
(C) Fluorometer
(D) Luminometer
Answer: (C) Fluorometer
Question 33:
In Enzyme Immunoassays (EIA), what are used as labels?
(A) Radioactive isotopes
(B) Fluorescent compounds
(C) Enzymes
(D) Chemicals
Answer: (C) Enzymes
Question 34:
How is a positive result measured in an Enzyme Immunoassay (EIA)?
(A) Change in radioactivity
(B) Fluorescence intensity
(C) Color change
(D) Light emission
Answer: (C) Color change
Question 35:
What is the emission of light caused by a chemical reaction used in?
(A) Radioimmunoassay (RIA)
(B) Immunofluorescence (IF)
(C) Enzyme immunoassay (EIA)
(D) Chemiluminescent immunoassay
Answer: (D) Chemiluminescent immunoassay
Question 36:
What instrument is used to measure the light emitted in a Chemiluminescent immunoassay?
(A) Fluorometer
(B) Spectrophotometer
(C) Scintillation counter
(D) Luminometer
Answer: (D) Luminometer
Formats of Labeled Immunoassays
Question 37:
In which format are all reactants mixed simultaneously?
(A) Noncompetitive
(B) Competitive
(C) Homogeneous
(D) Heterogeneous
Answer: (B) Competitive
Question 38:
In a competitive immunoassay, the amount of bound labeled antigen is ________ proportional
to the concentration of antigen in the patient's sample.
(A) Directly
(B) Inversely
(C) Equally
(D) Not
Answer: (B) Inversely
Question 39:
In which format does the amount of label measured is directly proportional to the amount of
patient antigens?
(A) Competitive
(B) Noncompetitive
(C) Homogeneous
(D) Both Competitive and Noncompetitive
Answer: (B) Noncompetitive
Question 40:
Which format requires a separation step?
(A) Homogeneous
(B) Heterogeneous
(C) Competitive
(D) Non-competitive
Answer: (B) Heterogeneous
Question 41:
Which format does NOT require a separation step?
(A) Heterogeneous
(B) Homogeneous
(C) Competitive
(D) Non-competitive
Answer: (B) Homogeneous
