3.4 Flashcards
What is a general definition for autoimmunity?
A. Increase of tolerance to self antigens
B. Loss of tolerance to self-antigens
C. Increase in clonal deletion of mutant cells
D. Manifestation of immunosuppression
B. Loss of tolerance to self-antigens
An antinuclear antibody test is performed on a specimen from a 55-year-old woman who has unexplained joint pain. The IFA result is a titer of 40 and a homogeneous pattern. The appropriate follow-up for this patient is:
A. Anti-DNA assay
B. Extractable nuclear antigen (ENA) testing
C. Retest ANA in 3-6 months
D. CH50 complement assay
C. Retest ANA in 3-6 months
Which disease is likely to show a rim (peripheral) pattern in an immunofluorescence (IF) microscopy test for ANA?
A. Mixed connective tissue disease (MCTD)
B. Rheumatoid arthritis
C. Systemic lupus erythematosus
D. Scleroderma
C. Systemic lupus erythematosus
A patient’s specimen is strongly positive in an ANA ELISA. Which of the following would not be an appropriate follow up to this result?
A. Immunofluorescence test on HEp-2 cells
B. Specific ENA ELISA tests
C. Specific anti-DNA ELISA
D. Rheumatoid factor assay
D. Rheumatoid factor assay
What type of antibodies is represented by the solid or homogeneous pattern in the immunofluorescence test for antinuclear antibodies?
A. Antihistone antibodies
B. Anticentromere antibodies
C. Anti-ENA (anti-Sm and anti-RNP) antibodies
D. Anti-RNA antibodies
A. Antihistone antibodies
What disease is indicated by a high titer of anti-Sm (anti-Smith) antibody?
A. Mixed connective tissue disease (MCTD)
B. RA
C. SLE
D. Scleroderma
C. SLE
Which disease is least likely when a nucleolar pattern occurs in an immunofluorescence test for antinuclear antibodies?
A. MCTD
B. Sjögren’s syndrome
C. SLE
D. Scleroderma
A. MCTD
What antibodies are represented by the nucleolar pattern in the immunofluorescence test for antinuclear antibodies?
A. Antihistone antibodies
B. Anti-dsDNA antibodies
C. Anti-ENA (anti-Sm and anti-RNP) antibodies
D. Anti-RNA antibodies
D. Anti-RNA antibodies
Which test would best distinguish between SLE and MCTD?
A. Multiplex or ELISA test for anti SM and anti-RNP
B. Immunofluorescence testing using Crithidia as substrate
C. Slide agglutination testing
D. Laboratory tests cannot distinguish between these disorders
A. Multiplex or ELISA test for anti SM and anti-RNP
An ANA test on HEp-2 cells shows nucleolar staining in interphase cells and dense chromatin staining in mitotic cells. The most likely cause of this staining pattern is:
A. Antifibrillarin antibody
B. Antiribosomal p antibody
C. A serum with nucleolar and homogeneous patterns
D. Technical artifact
A. Antifibrillarin antibody
Which immunofluorescence pattern indicates the need for ENA testing by Ouchterlony immunodiffusion, Multiplex, or ELISA assays?
A. Homogeneous or solid
B. Peripheral or rim
C. Speckled
D. Nucleolar
C. Speckled
Which of the following is used in rapid slide tests for detection of rheumatoid factors?
A. Whole IgM molecules
B. Fc portion of the IgG molecule
C. Fab portion of the IgG molecule
D. Fc portion of the IgM molecule
B. Fc portion of the IgG molecule
Which of the following methods is least likely to give a definitive result for the diagnosis of RA?
A. Nephelometric measurement of anti-IgG
B. Agglutination testing for rheumatoid factor
C. Anti CCP
D. Immunofluorescence testing for antinuclear antibodies
D. Immunofluorescence testing for antinuclear antibodies
Which disease might be indicated by antibodies to smooth muscle?
A. Atrophic gastritis
B. Autoimmune hepatitis
C. Myasthenia gravis
D. Sjögren’s syndrome
B. Autoimmune hepatitis
Antibodies to thyroid peroxidase can be detected by using agglutination assays. Which of the following diseases may show positive results with this type of assay?
A. Graves’ disease and Hashimoto’s thyroiditis
B. Myasthenia gravis
C. Granulomatous thyroid disease
D. Addison’s disease
A. Graves’ disease and Hashimoto’s thyroiditis
