Complete BOC Immunology (MLT only) Exam (Latest
2024/2025) Questions with Verified Answers
+Rationale/ Grade A Score Guide (Medical Laboratory
Technicians)
1) Antinuclear antibody tests are performed to help diagnose?
a) acute leukemia
b) lupus erythematosus
c) hemolytic anemia
d) Crohn disease - ANSWERb (lupus erythematosus)
2. In the anti-double-stranded DNA procedure, the antigen most commonly utilized
is:
a. rat stomach tissue
b. mouse kidney tissue
c. Crithida lucilia
d. Toxoplasma gondii - ANSWERc (Crithida lucilia)
3) Which of the ANA patterns shown above would be associated with high titers of
antibodies to the Sm antigen?
a) diagram A
b) diagram B
c) diagram C
d) diagram D - ANSWERc (diagram C)
4) Sera to be tested for IFA-ANA 6 days after drawing is best stored at?
a) room temperature
b) 5°C +/- 2°
c) -70°C in a constant temperature freezer
d) -20°C in a frost-free self-defrosting freezer - ANSWERb (5°C +/- 2°)
5) Antibodies directed at native DNA are most frequently associated with which
pattern of fluorescence in the IFA-ANA test?
a) rim
b) diffuse
c) speckled
d) centromere - ANSWERa (rim)
6) The technologist observes apparent homogenous staining of the nucleus of
interphase cells while performing an IFA-ANA, as well as staining of the
chromosomes in mitotic cells. This result is:
a) indicative of 2 antibodies, which should be separately reported after titration
b) expected for anti-DNA antibodies
c) inconsistent; the test should be reported with new reagent
,d) expected for anti-centromere antibodies - ANSWERb (expected for anti-DNA
antibodies)
7) The result of an anti-nuclear antibody test was a titer of 1:320 with a peripheral
pattern. Which of the following sets of results best correlate with these results?
a) anti-dsDNA titer 1:80, and a high titer of antibodies to Sm
b) antimitochondrial antibody titer 1:160, and antibodies to RNP
c) anti-Scl-70, and antibodies to single-stranded DNA
d) high titers of anti-SS-A and anti-SS-B - ANSWERa (anti-dsDNA titer 1:80, and a high
titer of antibodies to Sm)
8) Systemic lupus erythematosus patients often have which of the following test
results?
a) high titers of DNA antibody
b) decreased serum immunoglobulin levels
c) high titers of anti-smooth muscle antibodies
d) high titers of antimitochondrial antibody - ANSWERa (high titers of DNA antibody)
9. Systemic lupus erythematosus patients with active disease often have which of
the following test results?
a. high titers of antimicrosomal antibodies
b. high titers of anti-smooth muscle antibodies
c. marked decrease in serum CH50
d. decreased serum immunoglobulin levels - ANSWERc (marked decrease in serum
CH50)
10. Which of the following is decreased in serum during the active stages of systemic
lupus erythematosus?
a. anti-nuclear antibody
b. immune complexes
c. complement (C3)
d. anti-DNA - ANSWERc (complement (C3))
11. A positive ANA with the pattern of anticentromere antibodies is most frequently
seen in patients with:
a. rheumatoid arthritis
b. systemic lupus erythematosus
c. CREST syndrome
d. Sjӧgren syndrome - ANSWERc (CREST syndrome)
12. In the indirect fluorescent anti-nuclear antibody test, a homogenous pattern
indicates the presence of antibody to:
a. RNP
,b. Sm
c. RNA
d. DNA - ANSWERDNA
13. In the indirect fluorescent anti-nuclear antibody test, a speckled pattern may
indicate the presence of antibody to:
a. histone
b. Sm
c. RNA
d. DNA - ANSWERb (Sm)
14) A patient has the following test results:
The above results could be seen in patients with:
a) rheumatic fever
b) rheumatoid arthritis
c) lupus erythematosus
d) glomerulonephritis - ANSWERc (lupus erythematosus)
15. Autoantibodies in the absence of Sm are found in patients with:
a. mixed connective tissue disease
b. systemic lupus erythematosus
c. Crohn disease
d. multiple myeloma - ANSWERa (mixed connective tissue disease)
16) Which of the following is the most sensitive and appropriate method for the
detection of rheumatoid factor?
a) nephelometry
b) immunofixation electrophoresis
c) immunofluorescence
d) manual latex agglutination - ANSWERa (nephelometry)
17) Rheumatoid factor reacts with:
a) inert substances such as latex
b) Rh-pos erythrocytes
c) kinetoplasts of Crithidia luciliae
d) gamma globulin-coated particles - ANSWERd (gamma globulin-coated particles)
18) A consistently and repeatedly negative IFA-ANA is:
a) strong evidence against untreated SLE
b) associated with active SLE
c) characteristic of SLE with renal involvement
d) associated with lupus inhibitor - ANSWERa (strong evidence against untreated
SLE)
, 19) Positive rheumatoid factor is generally associated with:
a) hyperglobulinemia
b) anemia
c) decreased erythrocyte sedimentation rate
d) azotemia - ANSWERa (hyperglobulinemia)
20) The following results are from rubella titer performed on acute and convalescent
sera using 2-fold serial dilution:
Date tested: 1/23/04
Acute serum titer: 1:8
Convalescent serum titer: 1:32
After evaluating the above results, best interpretation is:
a) results are consistent with active infection with rubella
b) variation in the acute serum titers invalidates these results
c) test should be repeated by a different technologist
d) patient was not infected with rubella - ANSWERa (results are consistent with
active infection with rubella)
21) Rheumatoid factors are immunoglobulins with specificitiy for allotypic
determinants located on the:
a) Fc fragment of IgG
b) Fab fragment of IgG
c) J chain of IgM
d) secretory of component of IgA - ANSWERa (Fc fragment of IgG)
22) Rheumatoid factor in patients serum may cause a false:
a) positive test for the detection of IgM class antibodies
b) negative test for the detection of IgM class antibodies
c) positive test for the detection of IgG class antibodies
d) negative test for the detection of IgG class antibodies - ANSWERa (positive test for
the detection of IgM class antibodies)
23) Rheumatoid factors are defined as:
a) antigens found in the sera of patients with rheumatoid arthritis
b) identical to the rheumatoid arthritis precipitin
c) autoantibodies with specificity for the Fc portion of the immunoglobulin (IgG)
molecule
d) capable of forming circulating immune complexes only when IgM-type
autoantibody is present - ANSWERc (autoantibodies with specificity for the Fc
portion of the immunoglobulin (IgG) molecule)
24. Tissue injury in systemic rheumatic disorders such as systemic lupus
erythematosus is thought to be caused by:
a. Cytotoxic T cells
b. IgE activity
c. deposition of immune complexes
2024/2025) Questions with Verified Answers
+Rationale/ Grade A Score Guide (Medical Laboratory
Technicians)
1) Antinuclear antibody tests are performed to help diagnose?
a) acute leukemia
b) lupus erythematosus
c) hemolytic anemia
d) Crohn disease - ANSWERb (lupus erythematosus)
2. In the anti-double-stranded DNA procedure, the antigen most commonly utilized
is:
a. rat stomach tissue
b. mouse kidney tissue
c. Crithida lucilia
d. Toxoplasma gondii - ANSWERc (Crithida lucilia)
3) Which of the ANA patterns shown above would be associated with high titers of
antibodies to the Sm antigen?
a) diagram A
b) diagram B
c) diagram C
d) diagram D - ANSWERc (diagram C)
4) Sera to be tested for IFA-ANA 6 days after drawing is best stored at?
a) room temperature
b) 5°C +/- 2°
c) -70°C in a constant temperature freezer
d) -20°C in a frost-free self-defrosting freezer - ANSWERb (5°C +/- 2°)
5) Antibodies directed at native DNA are most frequently associated with which
pattern of fluorescence in the IFA-ANA test?
a) rim
b) diffuse
c) speckled
d) centromere - ANSWERa (rim)
6) The technologist observes apparent homogenous staining of the nucleus of
interphase cells while performing an IFA-ANA, as well as staining of the
chromosomes in mitotic cells. This result is:
a) indicative of 2 antibodies, which should be separately reported after titration
b) expected for anti-DNA antibodies
c) inconsistent; the test should be reported with new reagent
,d) expected for anti-centromere antibodies - ANSWERb (expected for anti-DNA
antibodies)
7) The result of an anti-nuclear antibody test was a titer of 1:320 with a peripheral
pattern. Which of the following sets of results best correlate with these results?
a) anti-dsDNA titer 1:80, and a high titer of antibodies to Sm
b) antimitochondrial antibody titer 1:160, and antibodies to RNP
c) anti-Scl-70, and antibodies to single-stranded DNA
d) high titers of anti-SS-A and anti-SS-B - ANSWERa (anti-dsDNA titer 1:80, and a high
titer of antibodies to Sm)
8) Systemic lupus erythematosus patients often have which of the following test
results?
a) high titers of DNA antibody
b) decreased serum immunoglobulin levels
c) high titers of anti-smooth muscle antibodies
d) high titers of antimitochondrial antibody - ANSWERa (high titers of DNA antibody)
9. Systemic lupus erythematosus patients with active disease often have which of
the following test results?
a. high titers of antimicrosomal antibodies
b. high titers of anti-smooth muscle antibodies
c. marked decrease in serum CH50
d. decreased serum immunoglobulin levels - ANSWERc (marked decrease in serum
CH50)
10. Which of the following is decreased in serum during the active stages of systemic
lupus erythematosus?
a. anti-nuclear antibody
b. immune complexes
c. complement (C3)
d. anti-DNA - ANSWERc (complement (C3))
11. A positive ANA with the pattern of anticentromere antibodies is most frequently
seen in patients with:
a. rheumatoid arthritis
b. systemic lupus erythematosus
c. CREST syndrome
d. Sjӧgren syndrome - ANSWERc (CREST syndrome)
12. In the indirect fluorescent anti-nuclear antibody test, a homogenous pattern
indicates the presence of antibody to:
a. RNP
,b. Sm
c. RNA
d. DNA - ANSWERDNA
13. In the indirect fluorescent anti-nuclear antibody test, a speckled pattern may
indicate the presence of antibody to:
a. histone
b. Sm
c. RNA
d. DNA - ANSWERb (Sm)
14) A patient has the following test results:
The above results could be seen in patients with:
a) rheumatic fever
b) rheumatoid arthritis
c) lupus erythematosus
d) glomerulonephritis - ANSWERc (lupus erythematosus)
15. Autoantibodies in the absence of Sm are found in patients with:
a. mixed connective tissue disease
b. systemic lupus erythematosus
c. Crohn disease
d. multiple myeloma - ANSWERa (mixed connective tissue disease)
16) Which of the following is the most sensitive and appropriate method for the
detection of rheumatoid factor?
a) nephelometry
b) immunofixation electrophoresis
c) immunofluorescence
d) manual latex agglutination - ANSWERa (nephelometry)
17) Rheumatoid factor reacts with:
a) inert substances such as latex
b) Rh-pos erythrocytes
c) kinetoplasts of Crithidia luciliae
d) gamma globulin-coated particles - ANSWERd (gamma globulin-coated particles)
18) A consistently and repeatedly negative IFA-ANA is:
a) strong evidence against untreated SLE
b) associated with active SLE
c) characteristic of SLE with renal involvement
d) associated with lupus inhibitor - ANSWERa (strong evidence against untreated
SLE)
, 19) Positive rheumatoid factor is generally associated with:
a) hyperglobulinemia
b) anemia
c) decreased erythrocyte sedimentation rate
d) azotemia - ANSWERa (hyperglobulinemia)
20) The following results are from rubella titer performed on acute and convalescent
sera using 2-fold serial dilution:
Date tested: 1/23/04
Acute serum titer: 1:8
Convalescent serum titer: 1:32
After evaluating the above results, best interpretation is:
a) results are consistent with active infection with rubella
b) variation in the acute serum titers invalidates these results
c) test should be repeated by a different technologist
d) patient was not infected with rubella - ANSWERa (results are consistent with
active infection with rubella)
21) Rheumatoid factors are immunoglobulins with specificitiy for allotypic
determinants located on the:
a) Fc fragment of IgG
b) Fab fragment of IgG
c) J chain of IgM
d) secretory of component of IgA - ANSWERa (Fc fragment of IgG)
22) Rheumatoid factor in patients serum may cause a false:
a) positive test for the detection of IgM class antibodies
b) negative test for the detection of IgM class antibodies
c) positive test for the detection of IgG class antibodies
d) negative test for the detection of IgG class antibodies - ANSWERa (positive test for
the detection of IgM class antibodies)
23) Rheumatoid factors are defined as:
a) antigens found in the sera of patients with rheumatoid arthritis
b) identical to the rheumatoid arthritis precipitin
c) autoantibodies with specificity for the Fc portion of the immunoglobulin (IgG)
molecule
d) capable of forming circulating immune complexes only when IgM-type
autoantibody is present - ANSWERc (autoantibodies with specificity for the Fc
portion of the immunoglobulin (IgG) molecule)
24. Tissue injury in systemic rheumatic disorders such as systemic lupus
erythematosus is thought to be caused by:
a. Cytotoxic T cells
b. IgE activity
c. deposition of immune complexes
