AMT Imm Quick Flashcards

Question 1

Q

Two primary lymphoid organs…

3 secondary lymphoid organs…makes lymphs and plasmas…

both T and B cells are made in the…
T cells diff/are…dependent
B cells matuure in the…

Immunity
T cells are…
B cells are part of…

Answer

A

primary: Bone marrow, thymus

secondary: lymph nodes, spleen, tonsils

T/B cells made in Bone marrow
-T cells diff in thymus, B in bone marrow

T cells are cell mediated, intracellular
-give off small polypeptides called lymphokines to regulate phaogcytic cells
-Tcyto kill specific
-Thelper help B make ab

B cells are humor, extracellular

Question 2

Q

T cell markers…

B cell markers…

NK cell markers…

Answer

A

T cell: 2,3,4,8,25
-TH CD4: MHC2
-TCyto CD8: MHC1

Bcells surface immunoglobulin: 19,20,21

NK:16,56

Question 3

Q

MHC: genes control expression of HLA ag
Class 1:

Class 2:

involved in 3 things…

Answer

A

Class 1: HLA A,B,C
-present ag inside cell

Class 2: HLA-D M,O,P,Q,R
-present ag outside cell

involved in histocompatibility, genetic suspectibility…
-organ transplant
-paternity testing
-autoimmune disease associations

Question 4

Q

Most concentration of Ig, least concentration of Ig…
most to least/decreasing order…

best precipitin…
best agglutinin…

Answer

A

most is IgG, least if IgE
G>A>M>D>E

precipitin: IgG
incomplete

agglutinin: IgM
complete

Question 5

Q

Ig…

1 pentamer
1 dimer
3 monomers

which two with j chains

which one has 4 subclases, which has 2 subclasses

Answer

A

igM pentamer
igA dimer
igG,D,E monomers

igM and igA have Jchains and 2 subclasses

IgG has 1,2,3,4
-increases in convalescence phase

Question 6

Q

which Ig is an antigenic receptor on B cells

Question 7

Q

Region of antigen binding…

Region with disulfide bridge…

antibody class is determined by the antigenic variation in what region….

Hinge region is between…

Which chain is Fc region…

Answer

A

Region of antigen binding…variable region

Region with disulfide bridge…constant region

antibody class is determined by the antigenic variation in what region….constant region of heavy chain

Hinge region is between…CH1, CH2

Which chain is Fc region…heavy chain

Question 8

Q

Papain:
How many fragments…
which one is the antigen binding fragment…
which one is the crystallizable fragment…

Pepsin creates…

Answer

A

Papain:
How many fragments…3, 2 Fab, 1Fc

which one is the antigen binding fragment…Fab

which one is the crystallizable fragment…Fc

Pepsin creates…F(ab)2

Question 9

Q

complement is heat…

Classical pathway factors:
-recognition phase, order

Alternate pathway factors:

MB Lectin binds…

most abundant in both…

chemotactic factor/anaphylatoxin…

all lead to this complex…
ultimately…

Answer

A

heat labile

Classical: C1q(recognition), C4, C2, C3
-also C1r/s

Alternate: B, D, properdin

MB Lectin binds mannose on pathogens
MBL, MASP

chemotactic/anaphylatoxin..C5a

lead to MAC complex 56789, lysis

Question 10

Q

Precipitation versus Agglutination

Answer

A

Precipitation:
soluble ag plus soluble ab creat insolube complex/visible precipitate

agglutination: clumping/visible agg due to ag/ab; partigular ag aggregates form large complexes when ab present

Question 11

Q

Principle when RBCs agglutinated by a virus is not allowed to agglutinate because ab in serum inhibit the agglutination by neutralizing the virus

Answer

A

hemagglutination
inhibition

(Hemagglutination is inhibited by viral neutralization)

Question 12

Q

Make monoclononal ab with hybridoma which is

Answer

A

B lymphs fused to plasma myeloma cell

(from immunized animal)

only react with one epitope, don’t cross like/form precipitates/not good in precipitation hemmaglutination assays, can’t fix complement

Question 13

Q

Double radial diffusion also called…or…

non identity have lines of…

identity have lines of….

parital identity have lines of…

Answer

A

Double radial diffusion also called…
Ouchterlony or double immunodiffusion

non identity have lines of…intersection

identity have lines of….fusion

parital identity have lines of…partial identity

Question 14

Q

Another name for electrophoresis and double immunodiffusion

Answer

A

immuno-electrophoresis

answer has full word electrophoresis at end

I believe CIE is a form of this…
-ab/ag diffuse thru agar

Question 15

Q

Immunoelectrophoresis is a combination of…
Immunoelectrophoresis is not…

used to id proteins in both…
urine proteins called….

procedure to id monoclonal ig…

Answer

A

electrophoresis and double immunodiffusion
-not electroimmunodiffusion(single)

both serum/urine
-urine bence jones

immunofixation: light chains lamda,kappa

Question 16

Q

protein electrophoresis + immunodiffusion

-electrophorese proteins
-antiserum fixed to plate using strips agrarose
-bands of precipitation
-monoclonal gammapathies/light/heavy chains

Answer

A

immunofixation

Question 17

Q

CIE, counter current electrophoresis can show this pattern

-2 columns of wells in gel, ag to one, ab to other; current applied and they migrate towards each other, precipitate forms

Answer

A

gull wing:

Question 18

Q

electroimmunodiffusion has two other names

directed mvt on

Answer

A

rocket electrophoresis

1D single electroimmunodiffusion

semisolid media
-gel has ab, add STD/CTRLS to other wells, electric current, cone shaped precipitate/rocket

Question 19

Q

Flurochrome with minimal false readings…

Fluorochrome thats red at 580…

Flurochrome for tissue…

Energy source for fluouresent microscope…

Answer

A

Flurochrome with minimal false readings…FITC fluorescein isothicynate

Fluorochrome thats red at 580…TR-ITC tetra-methyl-rhodamine isothicyanate

Flurochrome for tissue…biotin avidin

Energy source for fluouresent microscope…mercury vapor lamp
-very bright light

Question 20

Q

Sandwich immunoassay is …and….

ELISA
what can be attached to solid phase
what is enzyme and what is enzyme linked to

Answer

A

noncompetitive, activity ab direclty proportional to ag
heterogeous
-requires wash step

solid phase well ELISA plates or beads and ag or ab

-ag/ab to well
-PT serum/incubate
-enzyme(horseradish peroxidase linked to AHG
-wash

Question 21

Q

Complement fixation consists of test and indicatior, what is indicator…

Controls to check anticomplementary factors/neg ctrls will show…

Pos control will show…

Thus PT with ab fixed complement will show….

Answer

A

Complement fixation consists of test and indicatior, what is indicator…
SRBCs sensitized with antisheep hemolysin

Controls to check anticomplementary factors/neg ctrls will show…hemolysis

Pos control will show…no hemolysis

Thus PT with ab fixed complement will show inhibition of hemolysis(complement can’t be used to lyze indicator SRBCs)

*must heat inactivate PT serum, only detects IgG

Question 22

Q

PT with syphillus:
develope antibody… to the nontreponemal ag…

VDRL/RPR are what kind of tests…

Answer

A

ab: reagin
ag: cardiolipn

nontreponemal flocculation tests

Question 23

Q

VDRL:

ag…

serum: ag…
drops of ag…
drops of saline…
check daily

what heat at, how long…
if not tested w/in 4hrs, how long heat…
why heat…

weakly reactive…

can also use this specimen to test…

Answer

A

VDRL:

ag…cardiolipin, lecithin

serum: ag…3:1
drops of ag…60
drops of saline…100

-30 drops/0.5ml, 60drops/1ml
-what heat at, how long…56C, 30min
-if not tested w/in 4hrs, how long heat…56C,10min
-heat inactivates complement

-QL: weak reactive is small clumps with many free particles, do quantitative/titer if reactive or weak
-QUANT: highest dilution giving a reative result(not weakly)

can also use this specimen to test…CSF

Question 24

Q

RPR:
no heat, less specific
uses plastic coated cells

ag…
drops of ag…

rpm/min

reactive=

Testing needle for accuracy…

Answer

A

cardiolipin, charcoal
60 drops ag

100rpm/8min

reactive=black clumps

Testing needle for accurary: fill with antigen, hold vertically, count drops in 0.5mL, 30 + or - 1 in 0.5ml is good

Question 25

Q

Treponemal test:

TPI uses…

FTA-ABS:
ids..in serum..
which treponemal is most sensitive..
sorbant is called…
flourescence label is…and helps…

Microhemmagglutination Test that isn’t likely to be reactive in primary/early secondary…

TP test that uses dilute serum and TP sensitized gelatin particles w/TP ag

Answer

A

TPI immobilizes/uses alive TP to PT serum

FTA-ABS
-ids treponemal ab in serum
-most senstive is FTA,ABS
-sorbant is Reiters, removes nonspecific ab, R=removes=reiter
-fluorescent label is flurescein isothiocyanate
with AHG and helps make ag-ab visible

MHA-TP:
-not as senstive in primary/secondary
-PT serum+ SRBC sensitized with TP, agg

TP particle agglutination:
-dilute Pt serum plus TP sensitized gelatin particles w/TP ag
-ab=agg, smooth mat on well

Question 26

Q

5 Streptococcal antigens

Antigen test: GAS grp A strep ag
LFA/molecular

Answer

A

5 Strep antigens:
-streptolysin O (O=oxygen labile)
-streptokinase(dissolves fibrin)

-DNase B, NADase
-hyaluronidase

Question 27

Q

Strep A tests:
Tests for antibody:
Type of cells used…

Two tests deal with agglutination, agg=ab..

Answer

A

Antibody detection:
1.)Agglutination:

-anti-streptolysin O slide test:
tests for antibody to streptolysin O
SRBC, PT ab=agg

-streptozyme: slide agg for all 5 ab
SRBC+ab=agg
-PT antibody detected with antigen coated to SRBC

-

Question 28

Q

Strep A tests:
tests for antibody

2 tests are neutralizations…ab=no hemolysis or no change

Answer

A

2.)Neutralizations:

antistreptolysin O tube test:
-hemolysis inhibition,
-streptolysin O antibody in serum keeps strepO from lysing reagent grpO cells
-no hemolysis, Todds units

-anti-DNase B, pos ab=green stays/isn’t hydrolyzed, it is neutralized
-glomerulonephritis

Question 29

Q

Principle of ASO tube test…

titer measured in…

Answer

A

hemolysis inhibition

Todd/IU
-dilution of last tube no hemolysis

Question 30

Q

Rapid slide test:

Heterophil antibody test positive is and is reported as…

Paul Bunnel is a rapid diff slide test that uses…rbc as an indicator
-IM will agglutinate what kind of rbc
-Forsmann ab will be…by what kind of rbc

Test that diff between the 3 types of heterophile ab….and uses these two rbcs

Answer

A

Stimulated by one antigen, react with unrelated antigen, 1:56 IgM reacts with horse,ox, sheep rbc

Rapid Mono slide test, monspot: heterophile ag, latex agglutination, guinea pig adsorption and horse rbc to detect IM

Positive is agglutination and reported as highest dilution with agglutination

-uses SRBC as indicator
-IM PTs will agglutinate kidney
-but Forsmann ab will be absorbed by the guinea pig kidney

Davidsohn diff test: uses sheep, horse rbcs

Question 31

Q

Widal and Weil felix detect…

Widal elevated O titer indicates…

Weil Felix detects ab to…
-uses OX19/O2 ag which are..strains

Answer

A

Widal and Weil felix detect febrile agglutinins

Widal increased O titer indicates increased agglutinins to S.typhi

Weil Felix detecs ab to rickettsia using proteus strains OX19/2

Question 32

Q

Confirm EBV with…

IgM antiVCA, antiEA, IgG antiVCA
w/out antiEBNA indicate…

anti EBNA, IgG antiVCA, with out IgM antiVCA indicates…

Answer

A

IIFA

Confirm EBV with…

IgM antiVCA, antiEA, IgG antiVCA
w/out antiEBNA indicate…current
*IgM=current, no EBNA=not past

anti EBNA, IgG antiVCA, with out IgM antiVCA indicates…past
*EBNA only in past, no IgM=not current

Question 33

Q

HSV: goes latent

HSV1: oral, can be urogenital
HSV2: more genital, urogenital, 90% genital, sex, mom baby

HSV3: VZV, chicken pox, ELISA
-Shingles: latent herpes zoster

HSV4: EBV
HSV5:CMV

Question 34

Q

ab to Brucella abortus will cross react with Franciella tularensis

aspergillosis titer of 1:512 is diagnostic

Question 35

Q

Cryptococcal antigen latex is replacing..
but interference from..

RF has….ab against the Fc portion of…

In the latex slide, PT serum is added to latex coated with…

Can also use…as a source of ab for RF latex

confirm RF with…

Answer

A

Cryptococcal antigen latex is replacing india ink; although antigen latex is interfered with RF

RF has IgM ab against the Fc portion of IgG
-RA type 3 hypersensitivity

In the latex slide, PT serum is added to latex coated with AHG
-agglutination not hema
-antibody is IgM

Can also use…as a source of ab for RF latex

confirm with antiCCP cycliccitrullinated peptide

Question 36

Q

mixed connective tissue ab

limited sclerosist/CREST ab

Answer

A

RNP

centromere/CREST

Question 37

Q

SLE ab…
pattern…

Scleroderma ab…

sjogrens syndrome ab…
-associated with what lymphoma

Answer

A

SLE: dsDNA, Sm
homogenous,diffuse
malar rash

Scleroderma: SCL

sjogrens syndrome ab: SS-A/B
-B cell lymphoma

Question 38

Q

Graves autoab…

Hashimotos ab…

Answer

A

Graves: autoab to TSH receptor
-TRab,TSHR, TSI

Hashimoto: auto ab against autoag thryroglobulin

Question 39

Q

Both chronic granulomatus disease and Chediak Higashi have issues with

Answer

A

neutrophils

CGD: ineffective phagocytosis=bacterial infections

Chediak: impaired segs

Question 40

Q

T cell def, no thymus

can be enumerated by flow

Answer

A

Digeorges

Question 41

Q

Complete/marked def of both T/B…

Partial combined immunodef/thrombocytopenia at birth…

sexlinked/males, absense of plasma cells/no ab
<100 CD19 B cells

Answer

A

SCID severe combined immun def
Complete/marked def of both T/B…

Partial combined immunodef/thrombocytopenia at birth…Wiskott Aldrich

Brutons agammaglobemia:
sexlinked/males, absense of plasma cells/no ab
<100 CD19 B cells

Question 42

Q

Serotype HSV..

Assay to type HSV to high specificity…

Answer

A

serotype…DFA

high specificyt: ELISA

Question 43

Q

VZV serological type..

rubella testing…and screen for immunity…

T.gondii serological testing…

Answer

A

VZV serological type..ELISA

rubella testing…ELISA
-screen for immunity IgG
-respiratory,cross placenta
-german measles, MMR

T.gondii serological testing…ELISA

Question 44

Q

CMV serological test…

false pos with what test…

Answer

A

CMV serological test…IgM/IgG antibody
-active: IgM, IgG 4 fold increase
-inactive: no IgM, IgG

false pos with indirect immunofluoresnce

Question 45

Q

Hypersensivity:

Type1:

Type2:

Type 3:

Type 4:

Answer

A

Hypersensivity:

Type1: immediate/anaphylactic, IgE
-asthma, bee (wheel, rash)

Type2: ab-ag complex
-transfusion, goodpasture(IgG,IgM)

Type 3: immune complexes
-RA, SLE

Type 4: delayed, dermatiditis
-TB skin test, Mantoux skin
-Poison ivy, GVHD

Question 46

Q

PCR: 3 steps to make copies

Answer

A

Denature, Anneal, Extend

Question 47

Q

RIA
competitive, inversely related to concen
RIST: IgE RAST: IgE to specific allergen

Question 48

Q

EMIT
enzyme multiplied
small molecules/hormones, color=pos

Question 49

Q

Immunoflurecense: ANA, FTA-ABS
-direct: fluorescein labeled ab to PT tissue
-indirect:PT serum to reagent, wash, flurescein labed AHG, wash

-Uses mercury vapor lamp-very bright
-FITC: fluorecein isothiocyanate
-TRITC: red 580nm, tetra-rhodamine-iso-thi-cyanate
-Tissue/culture=biotin=avidin

Question 50

Q

FPIA
Flourescence polarization IA
-ag reduces light
-ab +flurescent tagged ag, pos is decreased polarization

Question 51

Q

Rheumatoid arthristis tests:
chronic inflammation in joints/tissues

RF: serum or synovial fluid, soluble immune complexes; RF antiglobulins bind Fc fragment of IgG

What reaction is based between patient antibodies in the serum, known as the rheumatoid factor (RF), and an antigen derived from human gamma globulin (IgG)?

RF Slide: RA
-drop of serum on card plus latex reagent with AHG, mix, tilt/rotate for 2min, agglutination means RF present

Latex reagents consist of a stabilized latex suspension coated with albumin and chemically bonded with denatured human gamma globulin. This reagent serves as an antigen in the procedure. If rheumatoid factors (RFs) are present in the serum, macroscopic agglutination will be visible when the latex is mixed with the serum.

Answer

A

Rheumatoid arthristis tests:
chronic inflammation in joints/tissues

ESR: inflammation

CRP: protein made by immune system to inflammation

Anti-CCP:
-autoantibody cyclic citrullinated peptide

ANA: antinuclear antibody test
-autoantibody

Question 52

Q

5 Steps of phagocytosis

Answer

A

chemotaxis
adherence
engulf
phagosome
digest/destroy

Question 53

Q

Antibody response to antigenic/foreight, immune response phases

Answer

A

lag: no ab
log: titer increase log
plateau: titer stabilizes
decline: ag broken down

Question 54

Q

Two steps in agglutination

1.)Sensitiation: physical attachment dependent on
-ph 7.0
-temp: IgM 4-22, IgG 37
-incubation time 15-60min

2.)lattice: crosslinks between sensitized particles and antibodies

Question 55

Q

What three reactions have clear supernatants

Answer

A

2,3,4+

2+ medium, some free
3+large, some free
4+ one solid

Question 56

Q

What reactions have reddish supernatant

Answer

A

MF: most free
weak: barely visible, turbid
1+: small aggregates, free, turbid

Question 57

Q

PCR: amplify

Blots:

DNA:
RNA:
specific proteins:

Answer

A

DNA: southern
RNA: northern
specific proteins: Western, HIV

Question 58

Q

ELISA beta HCG
-chromatographic immunoassay
-antibody detects hcg

-beta HCG ab bound to solid medium
-any beta HCG will bind to it

-2nd monoclonal beta HCG +ALP will sandwich and make a bound ab-beta hcg-enzyme labeled ab

-incubation, washed
-chromagenic substrate added, color

Answer

A

Beta HCG maintains corpus luteum, stimulates progesterone

detectable amounts 2-3 days after implantation, 8-10 days after conception, 12 days after missed period

peak 2-3 months

SG 1.015 for urine

Question 59

Q

Infectious mononucleosis, EBV

actually increased reactive lymphs

can cause burkitts

DNA herpesvirus

Answer

A

Heterophil antibodies:
stimulated by one antigen and react with unrelated antigen

Sig nig titer 1:56

IgM reacts with horse, ox, sheep (horse best)

adsorbed by beef,
NOT ADSORBED by guinea pig kidney

Rapid slide:
agglutionation for detection of IM heterophile ab
-uses suspension of guinea pig kidney to adsorp and horse rbc to react
-1 min mix, agglutination is positive

Question 60

Q

Treponema pallidum:
spirochete, sex

darkfield for people with symptoms

primary: painless chancre

secondary: most contagious, highest amt, rash

latent: no symptoms, abortion

tertiary: 3-10yrs after primary, cardiac, degeneration of neurons

Answer

A

NONTREPONEMAL.Reagin:

Reagin: nontreponemal antibodies; against their own or other

Delivery needles:
-fill with antigenj, vertically count drops in 0.5ml; 30 plus or minus 1 drops in 0.5ml ok

RPR/rapid plasma reagin: screen
-agglutionation or floculation with soluble antigen particles
-RPR reagin card: charcoal particle cardiolipin antigen on card; floculation as black clumps on white background

VDRL:
veneral disease research labs
-serum and CSF
-serum heated 56C for 30min inactivate complement
-cardiolipin/lechithin on particles of cholesterol

….

TREPONEMAL tests:
-ab against antigen to confirm positive nontreponemal
-PT serum adsorbed with nonT.pall, fuorecein-conjugated AHG specific for anti-treponemal antibodies

FTA-ABS:
Fluroscent treponemal antibody-adsorption
-heat inactivated adsorbed with Reiter strain/Treponema
-fluorescent labeled AHG

TP-HA:
Treponemal-hemagglutination
-rbcs w/T.pall ag; gel particles

TP-PA:
Treponemal particle agglutination
-serum with colored gelatin particles with treponemal ag in microtiter plates, formation of mat is posisitve

MHA-TP: micro-hem-agglutination
-detects antibodies in serum/edta; fixed chix RBC or sheep rbc with T.pall, antibodies agglutinate the rbc

EIA:
-Competitive: T.pall ag in well, patient ab competes w/enzyme labeled anti-treponemal ab
-Immune capture: wells with IgM/G, serum, enzyme labeled T.pall ag added
-Sandwich: Patient ab bind to T.pall coated wells, enzymed labeled ab/ag added

Question 61

Q

Hep A: not chronic, no reinfection due to antibody protective for life; IgM to HAV

Hep B: DNA, IgM with EIA
-Acute: surface Ag, antiHBc, IgM
-high infectivity: e antigen
-window: anti-HBc
-recovered/immune/vaccination: anti-HBs
-past: anti-HBc IgG

Hep C: RNA, no vaccine, blood trans/needles
-EIA antiHCV

Hep D: RNA, needs B , superinfection, percutaneous

Answer

A

Order of appearance:

HBsAg, HBeAg
antiHBc, antiHBe, antiHBs

Question 62

Q

EBV: IM, Burkitt, from salivary

-Monospot: serum, sheep/horse RBC, agglutination is postive
-Mono diff test: 2 heterophile ab: Forssman, non; serum with 2 antigen suspensions guinea pig and beef rbc, tested with horse rbc;
*IM agglutinates with guinea pig kidney

EBV antigen specific serologic tests;
-acute: anti-VCA but no ebna
-convalesent/past: IgG antiVCA, antiEBNA

Question 63

Q

HIV

ELISA
-screen
-if pos, do 2nd/3rd tests and then confirm with western blot

Rapid screen:
-lateral flow

Question 64

Q

CMV: remains latent
-viral culture: shell vial, rapid centrifugation
-PCR
-EIA

Answer 54

A

ANA Patterns:

Homogenous or peripheral:
-suggests SLE is titer high

Speckled:
SLE

Nucleolar:
-RNA
-scleroderma

Centromere:
-CREST

Answer 55

A

Micro Hemagglutination Assay is one of the serological tests for syphilis. It is used to confirm that a positive nontreponemal test result has been caused by syphilis.

Answer 56

A

Antigens that can induce antibody production

Immunogens are antigens that can induce antibody production. Immunoassays utilize antigen-antibody reactions. Antigens and antibodies are used as very specific reagents.

Answer 57

A

Reproduce (amplify)

To reproduce, or amplify—previously, amplification of DNA involved cloning of the segments and took weeks, however, PCR methodology takes only a few hours.

Answer 58

A

Polyclonal antibodies

These antibodies are heterogeneous and lack the specificity of monoclonal antibodies.

Answer 59

A

The SLE Latex Test (Thermo Scientific, Waltham, MA) provides a suspension of polystyrene latex particles coated with deoxyribonucleoprotein (DNP). When the latex reagent is mixed with serum containing the ANAs, binding to the DNP-coated latex particles produces macroscopic agglutination. The procedure is positive in SLE and systemic rheumatic disease such as rheumatoid arthritis, scleroderma, and Sjogren’s syndrome.

Answer 60

A

Immune responses

ELISA uses components of the immune system and chemicals to detect immune responses in the body.

Answer 61

A

Rheumatoid arthritis (RA) agglutination test

Latex reagents consist of a stabilized latex suspension coated with albumin and chemically bonded with denatured human gamma globulin. This reagent serves as an antigen in the procedure. If rheumatoid factors (RFs) are present in the serum, macroscopic agglutination will be visible when the latex is mixed with the serum.

Answer 62

A

Solid-phase immunosorbent assay (SPIA)

A modification of SPIA uses a disposable plastic cassette consisting of the antibody-bound membrane and a small chamber to which the specimen can be added. An absorbent material is placed below the membrane to wick the liquid reactants through the membrane.

Answer 63

A

Titer: reciprocal of highest dilution gives reaction

4 fold increase is current

Brainscape's Knowledge GenomeTM

AMT Imm Quick Flashcards

Brainscape's Knowledge Genome^TM