4.2 review

Question 1

what is the direct Coombs test?

Answer 1

This is the test that is done on the newborn’s blood sample, usually in the setting of a newborn with jaundice. The test is looking for “foreign” antibodies that are already adhered to the infant’s red blood cells (rbcs), a potential cause of haemolysis and haemolytic disease in a newborn.

The two most commonly recognized forms of antibody-mediated hemolysis in newborns are Rh incompatibility and ABO incompatibility.

ON BABYS BLOOD TO SHOW ANTIBODIES ATTACHED

Question 2

what is an indirect Coombs test?

Answer 2

This is the test that is done on the mother’s blood sample serum as part of her prenatal labs. Frequently referred to as the “antibody screen”, this test identifies a long list of minor antigens that could either cause problems in the newborns or cause problems in the mother if transfusion is necessary.

ON MUMS SERUM TO SHOW ANTIBODIES THAT CAN ATTACH TO RBC

Question 3

what is the antigen and autoantibody in myasthenia graves?

Answer 3

antigen = acetylcholine receptor

auto antibody = anti-acetylcholine receptor antibodies

Question 4

what type of immune reaction is myasthenia gravis?

Answer 4

type II hypersensitivity

Question 5

what is used to treat myasthenia gravis?

Answer 5

pyridostigmine is a acetylcholinesterase inhibitor that binds to acetylcholinesterase and therapy reduces binding and degradation of ACh at the muscle end plate.

increases ACh sympathetic concentration and prolonging its action = more likely that AP and contraction ill occur in the muscle wall

Question 6

what is the self antigen and autoantibody in Rheumatoid arthritis?

Answer 6

Rheumatoid Factor = self antigen

anti-rheumatoid factor = rheumatoid arthritis

Question 7

what is the self antigen and autoantibody in lupus?

Answer 7

self antigen = double stranded DNA and other nuclear proteins (histones)

Question 8

what do the bloods in a patient with lupus typically show?

Answer 8

low red cell
low white cell
low platelets

Question 9

what effect can lupus have on the kidneys?

Answer 9

can get lupus glomerulonephritis = blood in urine = possible nephritic syndrome

Question 10

give some articular and non articular manifestations of rheumatoid arthritis.

Answer 10

articular

• synovial disease
• overproduction of TNFa leads to synovitis with joint destruction
• macrophages and T+B cell interactions drives into overproduction
• get an increase in IL-6 from TNFa action

Non articular

• pericarditis
• carpal tunnel
• anaemia
• bursitis
• lymphadenopathy
• leg ulcers