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Immunology CCMLS > autoimmunity > Flashcards

autoimmunity Flashcards

1
Q

A cold agglutinin titer end point is 1:16 after incubating overnight in the refrigerator and remains 1:16 after warming. The best course of action is to

A

report the titer as negative
test for antibody specificity

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2
Q

A false-negative cold agglutinin test may result if:

A

the specimen is refrigerated prior to serum separation

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3
Q

How should blood collected for a cold agglutinin determination BEST be treated before serum is separated for testing?

A

allow to clot at 37C

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4
Q

An example of a Type IV hypersensitivity reaction is:
a. allergic rhinitis
b. autoimmune hemolytic anemia
c. systemic lupus erythematosis
d. contact dermatitis

A

d. contact dermatitis

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5
Q

In the radial
immunodiffusion
(RID) procedure, which of the following pairs describe the locations of the reactants? a. antigen in the well, antibody in the agar
b. antibody in the well, antigen in the agar
c. antigen and antibody in individual wells
d. antigen in he well, antibody in the trough

A

a. antigen in the well, antibody in the agar

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6
Q

Antibodies to nDNA in the diagnosis of systemic lupus may be detected utilizing the protozoan Crithidia luciliae. The portion of the organism which will fluorescein a positive test is the

A

Kinetoplast
Nucleus

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7
Q

A peripheral patter in an antinuclear antibody (ANA) test is MOST characteristic of which disease listed?
a. Active systemic lupus erythematosus
b. Sjogren syndrome
c. Progressive systemic sclerosis
d. Scleroderma

A

a. Active systemic lupus erythematosus

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8
Q

Which
immunoglobulin
is associated with allergic reactions?

A

IgE

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9
Q

A patient has the following test results:
ANA = Positive 1:320
RA = Positive
Complement = Increased
ASO = 50 Todd Units
The above results would be seen in patients with:

A

Rheumatoid arthritis

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10
Q

A child has severe hay fever. A total IgE measurement was performed by the Ouchterlony
immunodiffusion method. No lines ofprecipitation appeared on the
immunodiffusion
plate. The most likely explanation is:

A

IgE is too low in concentration to be detected by this method

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11
Q

In systemic lupus
erythematosus
, high levels of which of the following antibodies are seen?

A

anti-DNA

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12
Q

Immediate Hypersensitivity

A

Type I Hypersensitivity

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13
Q

Allergy

A

Type I Hypersensitivity

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14
Q

Rheumatic Fever

A

Type III Hypersensitivity

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15
Q

Delayed Hypersensitivity

A

Type IV Hypersensitivity

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16
Q

Poison Ivy

A

Type IV Hypersensitivity

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17
Q

Innocent Bystander Destruction of Tissue

A

Type III Hypersensitivity

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18
Q

Host Rejection of Transplant Organs

A

Type IV Hypersensitivity

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19
Q

Rheumatoid Arthritis

A

Type III Hypersensitivity

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20
Q

Glomerulonephritis

A

Type III Hypersensitivity

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21
Q

Antigen-Antibody Complexes

A

Type III Hypersensitivity

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22
Q

Hemolytic Disease of the Newborn

A

Type II Hypersensitivity

23
Q

Thrombocytopenia purpura

A

Type II Hypersensitivity

24
Q

Which of the
immunoglobulins
is present in the highest concentration in normal human serum?

A

IgG

25
Q

Which of the following best described the slide agglutination test for rheumatoid factor?

A

it detects IgM autoantibodies made against the patient’s own IgG

26
Q

Cold agglutinins often occur in which disease state(s) and have what specificity?

A

primary atypical pneumonia, Anti-I
infectious mononucleosis, Anti-i

27
Q

In the direct fluorescent antinuclear antibody test, a speckled pattern, especially with symptoms of SLE, may indicate the presence of antibody to:

A

RNP

28
Q

The result of an antinuclear antibody test was a titer of 1:320 with a peripheral pattern. Which of the following sets of results bestcorrelates with these results?
a. anti-dsDNA titer 1:160, and a high titer of antibodies to Sm
b. anti-mitochondrial antibody titer 1:160, and antibodies to Sm
c. anti-r-6s RNP, and antibodies to single stranded DNA
d. high titers of anti-ssDNA and anti-centromere

A

a. anti-dsDNA titer 1:160, and a high titer of antibodies to Sm

29
Q

What type of antibodies are represented by the peripheral or rim pattern of
immunofluorescence
in tests for antinuclear antibody?

A

Anti-dsDNA antibodies

30
Q

What type of antibodies are represented by the solid or
homogeneous
pattern in the
immunofluorescence
test for antinuclear antibody?

A

Anti-histone antibodies

31
Q

In chronic active hepatitis, high titers of which of the following antibodies are seen?

A

Anti-smooth muscle

32
Q

What antibodies are represented by the nucleolar pattern in the
immunofluorescence
test for antinuclear antibody?

A

Anti-RNA antibodies

33
Q

Detection of which of the following substances is most useful in monitoring the course of a patient with testicular cancer?

A

Alpha feto-protein

34
Q

factors influencing autoimmunity

A

genetic: familial propensity
women>men
increased in HLA types
Increased w/ age

35
Q

classification of autoimmunity: organ specific examples

A

endocrine disorders (Hashimotos, Graves)
pernicious anemia
myasthenia gravis

36
Q

classification of autoimmuntiy: non organ specific examples

A

lupus
scleroderma

37
Q

rheumatoid arthritis

A

idiopathic
genetic predisposition
1-2% incidence worldwide
30-50 yo
female>male
all ages/races

38
Q

immunologic manifestation of rheumatoid arthritis

A

inciting event
rheumatoid factor formed: IgM against patients own IgG (Fe fragment)
heterogeneous grp of immune cmplxs formed in serum and joint fluid

39
Q

testing for rheumatoid arthritis

A

rheumatoid factor: latex agglutination (latex bead coated w/ IgG
RF present= agglutination
Antinuclear Antibodies (ANA): fluorescent technique

40
Q

systemic lupus erythematosus

A

idiopathic
autoantibodies against basement membranes in vascular system
hormonal influence (females btwn puberty and menopause)
african americans and native americans higher incidence

41
Q

drug induced systemic lupus erythematosus

A

birth control pills, procainamide

42
Q

symptoms of systemic lupus erythmatosus

A

inflamm
photosensitivity and facial rash
diffuse arthritis
renal, cardiac, respiratory, CNS involvement
poly arthritis and skin rash most common

43
Q

testing for systemic lupus erythmatosus

A

LE prep (LE cell)
ANA (only nucleus reacts w/ auto Ab

44
Q

scleroderma

A

rare autoimmune disease affecting blood vessels and connective tissues
fibrous degeneration of conn. tiss. of skin and internal organs
“progressive scleroderma”
CREST variant

45
Q

Sjorgren’s

A

autoimmune disorder assoc. w/ deficient moisture prod. of mouth, eyes, mucous membranes

46
Q

cold agglutinin testing

A

cold auto Ab
anti-i specificity (all adult O cells have anti-I on RBC anti-i only as newborn)
produced in adults during 1* atypical pneumonia (like Mycoplasma pneumonia)
test lacks sentivity

47
Q

procedure of cold agglutinin test

A

draw serum
keep warm (37*C) until serum separated from cells (to prevent false -)
make serial dilutions
add grp O washed cells
incubate overnight
look for aggluntination and read titer

48
Q

precipitation reactions: radial immunodiffusion

A

gel contains Ab
sample diffuses away from sample well
protein Ag or immunoglobulin ppt at zone of equivalence

49
Q

ppt rxns: Mancini RID endpoint method

A

take Z of E to exact endpoint
readings stable at this point
plot the diameter squared on regular graph paper

50
Q

ppt rxns: Fahey RKID timed diffusion method

A

read at pre-determined time (18 hrs)
reading unstable unless endpoint is reached
use semi-log paper and plot the ring diameter against [ ]

51
Q

ppt rxns: Ouchterlony immunodiffusion

A

Ab loaded in center well
Ag being tested loaded in outer wells
arcs of ppt. are formed: complete identify- boomerang pattern
partial identify pattern
non identify pattern

52
Q

ppt. rxns: Rocket electrophoresis

A

similar to RID
standards and patients in wells along on end of gel
electrical current applied across gel forming a rocket pattern at zone of equivalence

53
Q

ppt. rxns: immunoelectrophoresis

A

patient serum added to wells and fractions separated similar to electrophoresis
after separation antiserum added to each trough and allowed to diffuse overnight
ppt arcs are formed to [ ] of antisera added

Immunology CCMLS (12 decks)

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