An antigen contains epitopes for both antibodies will be ‘sandwiched’ between antibodies,free enzyme labeled washed away

Enzyme-linked immunosorbent assay (ELISA)

Cation-exchange particles contain negative charged functional group such as:

Carboxyl, phosphate or sulfonate ions

Held together by covalent inter-chain disulfide bonds joined to form a ‘Y’ shaped molecule

Two identical heavy (H) chains and two identical light (L)

Specific antibody binding sites found on an antigen

Epitope (antigenic determinant)

Small,— will rotate quickly,emitting polarized light.Larger,— will rotate slowly,emitting polarized light

Unbound fluorophore-labeled reagent — bound fluorophore-labeled reagent

Competitive method, Label is not inactivated by binding (type IV), measure with a luminometers

Chemiluminescent-Labeled immunoassay

Administrative & demographic Pt information provided by a center computer covering Pt admissions,transfer & discharges

ADT (Admission/Discharge/Transfer)

Substrate is added to the test system, but only free reagent antigen will catalyze the enzyme reaction

Enzyme-multiplied immunoassay technique (EMIT)

Common labels for immunoassay reactions?

Enzymes and fluorescent or chemiluminescent

The portion of an antigen (Ag) that an antibody interacts with is called

Antigenic determinant or epitope

The latter category of adsorption chromatography

Acidic (electron-accepting surface) and base (electron-donating surface)

Uses a competitive format,polarized light -> excite the fluorophore & measure the polarization of emitted light

Fluorescent-labeled immunoassay

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MLT 102 test 4 unit 6 review P2

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Questions 98

Answers

1
Body secretions such as saliva, tears, sweat, human milk and colostrum, approximately 15% of serum immunoglobulins
IgA
IgD
IgG
IgM
2
An antigen contains epitopes for both antibodies will be ‘sandwiched’ between antibodies,free enzyme labeled washed away
Enzyme-multiplied immunoassay technique (EMIT)
Enzyme-linked immunosorbent assay (ELISA)
Fluorescent-labeled immunoassay
Enzyme-labeled immunoassay
3
Cation-exchange particles contain negative charged functional group such as:
Carboxyl, phosphate or sulfonate ions
Phosphate, amino acids
Carboxyl, glycated hemoglobin
Amino acids, hemoglobin variants
4
A thin film of liquid is adsorbed or chemically bonded onto surface of support particles/inner wall of capillary column
Liquid-liquid chromatography (LLC)
Partition chromatography
Gas-liquid chromatography (GLC)
Support particles
5
The label may be measure on either the free or bound reagent antigen & is related to amount of patient antigen in sample
Type I
Type IV
Type III
Type II
6
Performed in the clinical chemistry lab use antibodies as the reagent in order to measure antigens of interest
Antigen
Immunogen
Immunoglobulins (Ig)
Immunoassay tests
7
The transport of quantity of analyte or reagent from one specimen reaction into & contaminating a subsequent one
Carryover
Order entry
Validation
Delta check
8
Held together by covalent inter-chain disulfide bonds joined to form a ‘Y’ shaped molecule
Two bottom portion of heavy chains
Two identical heavy (H) chains and two identical light (L)
All of above
The top of the “Y” structure
9
An analytical method that uses antibodies or antigens as reagent to measure specific chemicals, or analytes
Epitope (antigenic determinant)
Immunoassay
Immunoglobulins (Ig)
Immunogen
10
Energy of interaction of a single antibody-combing site and its corresponding epitope on the antigen
Avidity
Antibody
Affinity
Antigen
11
Responsible for the physiological manifestation of allergy, present in human serum in very low concentrations
IgE
IgD
IgA
IgG
12
Which classified of chromatography separation?
Affinity mechanism
Ion-exchange — Partition
Adsorption — Size-exclusion
All of above
13
Label is measured, the amount of label present is directly proportional to amount of the antigens
Type II
Type IV
Type I
Type III
14
Which one in results reporting reduced to second the delay associated with test results availability
All of above
Paper reports
LIS
EMR
15
Specific antibody binding sites found on an antigen
Epitope (antigenic determinant)
Immunogen
Immunoassay
Immunoglobulins (Ig)
16
Small,— will rotate quickly,emitting polarized light.Larger,— will rotate slowly,emitting polarized light
Bound fluorophore-labeled reagent — unbound fluorophore-labeled reagent
Fluorescent-labeled immunoassay — bound fluorophore-labeled reagent
Unbound fluorophore-labeled reagent — bound fluorophore-labeled reagent
Chemiluminescent-Labeled immunoassay — Fluorescent-labeled immunoassay
17
The operator reviews & approve or verify test results before they are released for pt reporting belong to
Automated result entry and Manual results entry
Instruments & interfaces
Data verification
All of above
18
LIS does not closely adapted to the needs of each laboratory and it’s organization
False
True
19
Alternate site - Ancillary - bedside - Decentralized - Near-patient and Physician office testing
POCT analyzer
Point-of-care testing (POCT)
POCT implementation
Order entry
20
Basic for critical health decisions (detection of disease, therapeutic drug monitoring, screening for drugs of abuse)
Immunogen
Antigen
Immunoglobulins (Ig)
Immunoassay results
21
Competitive method, Label is not inactivated by binding (type IV), measure with a luminometers
Fluorescent-labeled immunoassay
Chemiluminescent-Labeled immunoassay
Enzyme-multiplied immunoassay technique (EMIT)
Particle immunoassay
22
Single-site,non-competitive,known antigenic tagged w label,antigen contain specific epitopes -> binding -> measure label
Type I
Type II
Non-competitive immunoassays
Type III
23
Administrative & demographic Pt information provided by a center computer covering Pt admissions,transfer & discharges
Delta check
Carryover
ADT (Admission/Discharge/Transfer)
Order entry
24
The strength of the binding of an antigen to an antibody depends on the fit of the antigenic determinant (epitope)
Avidity
Immunogen
Affinity
Binding force
25
Substrate is added to the test system, but only free reagent antigen will catalyze the enzyme reaction
Fluorescent-labeled immunoassay
Enzyme-labeled immunoassay
Enzyme-linked immunosorbent assay (ELISA)
Enzyme-multiplied immunoassay technique (EMIT)
26
Commonly use preparative mode to separate large molecule (protein & nucleic acids from small one:salts & oligonucleotide
Adsorption chromatography
Size-exclusion chromatography
Partition chromatography
Avidity chromatography
27
Common labels for immunoassay reactions?
Fluorescent
Enzymes
Enzymes and fluorescent or chemiluminescent
Chemiluminescent and fluorescent
28
The portion of an antigen (Ag) that an antibody interacts with is called
Immunogens
Antigen
Antibody
Antigenic determinant or epitope
29
After additional washing to remove the excess unbound labeled antibody, the bound label is measured
Type II
Type I
Type III
Non-competitive immunoassay
30
The remaining label is measured, the amount of label is directly proportional to the amount of the antigen -> Pt sample
Type III
Type II
Non-competitive immunoassay
Type I
31
The latter category of adsorption chromatography
Affinity and avidity
Acidic (electron-accepting surface) and base (electron-donating surface)
Silica and alumina
Nonpolar and polar
32
A substance capable of inducing an immune response
Immunogen
Epitope (antigenic determinant)
Immunoglobulins (Ig)
Immunoassay
33
Uses a competitive format,polarized light -> excite the fluorophore & measure the polarization of emitted light
Chemiluminescent-Labeled immunoassay
Fluorescent-labeled immunoassay
Enzyme-multiplied immunoassay technique (EMIT)
Particle immunoassay
34
What are characteristics/requirements of POCT testing analyzer?
Reduce error & enhance Pt care - Rapid & timely manner -Portable instrument
Perform direct specimen (whole blood/urine) - Flexible test options
Built-in/integrated calibration,QC - Results provide - Low instruments cost
All of above
35
Cross the placenta, responsible for the immunological defense of the newborn
IgM
IgD
IgA
IgG
36
Clinical lab testing conduct close to patient care,refer any testing performed outside
POCT analyzer
Point-of-care testing (POCT)
Order entry
POCT implementation
37
Partition chromatography separation is based on differences in the relative solubility of solute molecules between
Stationary and mobile phases
Gas-liquid chromatography and liquid-liquid chromatography
Solute partitioning of stationary phase
Solute partitioning of mobile phase
38
Is unknown, present in human serum in trace amounts
IgE
IgA
IgG
IgD
39
analytical method uses antibodies or antigens as reagent to measure specific chemicals or analytes,reliable & sensitive
Epitope (antigenic determinant)
Immunoglobulins (Ig)
Immunogen
Immunoassay
40
Method of quality control by which the current Pt results is compared with a previous Pt result
Order entry
Validation
Carryover
Delta check
41
Which two types of adsorbents?
Nonpolar and polar
Silica and alumina
Affinity and avidity
Acidic and base
42
Time allowed for a chemical reaction or process to proceed to completion
Delta check
Validation
Incubation time
Pending (incomplete) list
43
Two-site,noncompetitive,patient specimens added to test system -> add second tagged antibody -> measure remaining label
Type II
Type III
Type IV
Type I
44
Which clinical applications of ion-exchange chromatography?
Hemoglobin variants
All of above
Amino acids, glycated hemoglobin
Oligonucleotides
45
LIS role in Testing and Analysis
Instruments & interfaces
All of above
Automated result entry and Manual results entry
Data verification
46
Measurement phase
Step 6
Step 2
Step 4
Step 5
47
Reagent system and delivery
Step 5
Step 2
Step 4
Step 6
48
What are the disadvantages of POCT?
More expensive- Management is challenging
Multiple sites to manage & hundreds test to validate
Difficult w/ documentation - Th result are not always comparable
All of above
49
After antibody-antigen reaction has occurred,determined by measuring the enzyme label by Spectrophotometry
Fluorescent-labeled immunoassay
Enzyme-linked immunosorbent assay (ELISA)
Enzyme-labeled immunoassay
Enzyme-multiplied immunoassay technique (EMIT)
50
Action of entering test orders into a computer system, this order prices may occur in LIS or remote computer linked LIS
Delta check
Validation
Order entry
Pending (incomplete) list
51
Based on an exchange of ions between a charged stationary phase and ions of the opposite charge in the mobile phase
Ion-exchange chromatography
Affinity mechanism
Oligonucleotides
Amino acids
52
Electronic database & computer system replace paper medical record: results reporting,order entry,image storage,..
Delta check
Order entry
Carryover
EMR (Electronic medical record)
53
Competitive procedure -> compete limited number -> binding of reagent antigen inactivated the enzyme (type III)
Enzyme-labeled immunoassay
Enzyme-multiplied immunoassay technique (EMIT)
Enzyme-linked immunosorbent assay (ELISA)
Fluorescent-labeled immunoassay
54
Binding of an antibody to an antigen is directly related to:
Affinity and avidity
Concentration of the antibody and epitopes
All of above
Specificity of antibody for antigen and Environmental conditions (pH, temp)
55
Which common types of enzyme-labeled immunoassay?
enzyme-multiplied immunoassays (EMIT)
Enzyme-linked (ELISA) and enzyme-multiplied immunoassays (EMIT)
Particle immunoassay
Enzyme-linked (ELISA)
56
Proteins with antibody activity
Immunoglobulins (Ig)
Immunogen
Epitope (antigenic determinant)
Immunoassay
57
Specimen preparation/separation
Step 3
Step 2
Step 4
Step 1
58
Analyte (enzyme,antibody,antigen,tissue receptor,.) binds to support-bound ligand,use antibody to antigens -> separation
Adsorption chromatography
Partition chromatography
Size-exclusion chromatography
Affinity chromatography
59
Immunoglobulin (Ig) class of molecule (IgA, IgG, IgM) that binds specifically to an antigen
Affinity
Avidity
Antigen
Antibody
60
LIS role in Pre-Analytical activities follow
Order entry and Bar codes
Patient demographics (Pt information) - Order entry and Bar codes
Enter and collect all patient information
Patient demographics (Pt information) - and Bar codes
61
The principal polar adsorbent used in liquid chromatography?
Affinity and avidity
Acidic and base
Silica and alumina
Nonpolar and polar
62
Produced compounds (luminol & acridinium esters -> ability to produce light energy (flash/glowing) by chemical reaction
Chemiluminescent-Labeled immunoassay
Particle immunoassay
Fluorescent-labeled immunoassay
Enzyme-multiplied immunoassay technique (EMIT)
63
Size-exclusive chromatography as known as
Molecular size
Avidity chromatography
Gel-filtration or molecular-sieve
Affinity chromatography
64
Are protein and have a common basic structure of four polypeptide chains
Immunoglobulins
Immunoassay
Affinity
Epitope
65
What are implementation, management & maintenance of POCT service requires?
Planing - Oversight - Inventory control - Assurance is reliable results
Planing - Oversight - Inventory control - Ensuring documentation
Planing - Establishment - Inventory control - Assurance is reliable results
Training - Oversight - Inventory control - Assurance is reliable results
66
Capture antibody is adsorbed/covalent bound -> labeled antigens added bound w/ second -> epitope -> measure bound label
Type II
Type I
Type III
Non-competitive immunoassays
67
Process whereby a technologist reviews one or more analyses & release the results to the patient file for reporting
Delta check
Pending (incomplete) list
Order entry
Validation
68
Turbidimetry & nephelometry,assess the formation of inhibition of precipitation/aggregation event,measure by photometry
Enzyme-multiplied immunoassay technique (EMIT)
Chemiluminescent-Labeled immunoassay
Fluorescent-labeled immunoassay
Particle immunoassay
69
Reporting list specimens have not yet been processed
Order entry
Pending (incomplete) list
Validation
Delta check
70
Predominant antibody in the initial immune response to an antigen, approximately 10% of serum immunoglobulins
IgA
IgE
IgD
IgM
71
What structure of antibody?
Two bottom portion of heavy chains
Two identical heavy (H) chains and two identical light (L)
All of above
The top of the “Y” structure
72
Competitive & heterogeneous,patient & labeled reagent compete for limit number -> binding site -> label not inactivated
Type IV
Type I
Type II
Type III
73
Produced naturally as a response to nature infections (Bacteria or virus) or acquired immunity in response vaccinations
Antigen
Avidity
Immunogen
Antibodies
74
Partition chromatography is classified as:
Liquid-liquid chromatography (LLC)
Gas-liquid chromatography (GLC)
Both Gas-liquid chromatography (GLC) and Liquid-liquid chromatography (LLC)
Support particles
75
The differential distribution of solutes between two immiscible (incapable mixed) liquids
Gas-liquid chromatography (GLC)
Liquid-liquid chromatography (LLC)
Partition chromatography
Support particles
76
Only free reagent antigen label is measured,amount of free reagent label is amount of patient antigen bound to antibody
Type III
Type II
Type IV
Type I
77
Which is one benefit of automation?
Reduction in variable of result & error of analysis
Permits increased workload
Performance of tests
Improve reproducibility
78
Specimen measurement and delivery
Step 4
Step 1
Step 2
Step 3
79
Subtracted enzyme-catalyzed reaction -> measure product of reaction -> amount enzyme activity = amount antigen present
Enzyme-labeled immunoassay
Enzyme-multiplied immunoassay technique (EMIT)
Fluorescent-labeled immunoassay
Enzyme-linked immunosorbent assay (ELISA)
80
Hydrogen bonding & interaction:the solute & surface hydroxyl (silica,acid washed alumina) & oxygen anionic (base-washed
Avidity chromatography
Size-exclusion chromatography
Affinity chromatography
The mechanism of separation
81
Binding forces depends on other factors:
Intermolecular forces, van set Waals force
Intermolecular forces and hydrophobic interactions
Van set Waals force and hydrophobic interactions
Intermolecular forces, van set Waals force and hydrophobic interactions
82
Specimen preparation and identification
Step 1
Step 3
Step 4
Step 2
83
Determine the antibody class or subclass
Two bottom portion of heavy chains
Two identical heavy (H) chains and two identical light (L)
The top of the “Y” structure
All of above
84
Competitive & homogeneous,patient & reagent antigen has been labeled in limited number -> binding inactivates label
Type IV
Type II
Type III
Type I
85
How many classes of antibodies (Immunoglobulins)?
IgG, IgM, IgA, IgE and IgD
IgG, IgM, IgA and IgE
IgG, IgA, IgE and IgD
IgG, IgM, IgA, IgD
86
What are advantages of the automation process?
All of the above
Permits increased workload w/out increase staff
Reduction in errors — Improve reproducibility
Performance of tests w/ minimal involvement by analyst
87
The most abundant of antibody?
IgD
IgE
IgM
IgG
88
To be used for testing purposes, require minimum samples, physically bind to antigen
Avidity
Antigen
Antibodies
Affinity
89
Overall strength of binding of antibody & antigen, the sum of the binding affinities of all individuals combining sites
Antigen
Avidity
Antibody
Affinity
90
Any material capable of reacting with an antibody without necessarily being capable of inducing antibody formation
Affinity
Antibody
Avidity
Antigen
91
Any material capable of interacting with an antibody, most antigens are Immunogens,not induce antibody formation
Immunogens
Immunoassay
Antigen
Antibody
92
Binds to epitopes of the antigen and has structural changes that result in the degree of antibody specification
The top of the “Y” structure
All of above
Two bottom portion of heavy chains
Two identical heavy (H) chains and two identical light (L)
93
Are a protein, or substance coupled to a carrier, forest host induces an immune response (formation antibodies)
Antigen
Immunoassay
Immunogens
Antibody
94
What are the advantages of POCT?
Reduced TAT of test results - Improved patient management
Reduction administrative work associated w/ test requesting
Opportunity more informed discussion-Reduced risk of error testing/process
All of above
95
All software, associated operating system,hardware needed to run programs support operations & management
EMR (Electronic medical record)
ADT (Admission/Discharge/Transfer)
Automated analysis
Laboratory information system (LIS)
96
Chemical reaction/incubation phase
Step 2
Step 5
Step 4
Step 6
97
More patent Ag allow more enzyme/labeled reagent antigen remain free & active,— is an indication of increased Patient Ag
Low enzyme activity
Greater enzyme activity
Immunoassay
Enzyme-linked
98
Which are immunoglobulins produced?
Specific antigens
Affinity and avidity
By a subset of lymphocytes (B lymphocytes) and by their progeny,plasma cell
Bacteria and virus

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