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TT BL and DD Exam1 > BL3 > Flashcards

BL3 Flashcards

1
Q

What is the serum concentration of:
IgG
IgA
IgM

A

IgG: 1000 mg/dL -> most abundant in plasma remember?
IgA: 200 mg/dL
IgM: 100 mg/dl

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2
Q

What is the combining site on the antibody?

A

where antibody binds to the antigen
○ Made up of V domains of both the H and L chain
○ 6 total

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3
Q

What is the difference between antigen precipitation and agglutination?
Which is easier to detect? (more sensitive?)

A

When the antigen is a molecule → called precipitation.

When antigen is cell/cell sized → called agglutination

agglutination easier to detect

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4
Q

What is the only class of antibody (Ig) that can pass the placenta?

A

IgG via active transport

bc placenta is gross

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5
Q

What is the only class of antibody (Ig) that is opsonizing?

A

IgG

phagocytic cells have receptors that recognize the Fc of bound IgG→ clearance of extracellular bacteria
- Helps other cells Gobble up bacteria (opsonizing)

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6
Q

What is the only antibody made by the fetus?

A

IgM

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7
Q

What is the first immunoglobulin seen in blood after immunization

A

IgM

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8
Q

Which Immunoglobulin is the most efficient complement activator? Why?

A

IgM

-always has 2 adjacent Fc’s to begin complement cascade.

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9
Q

Do phagocytes have IgM or IgG receptors?

A

IgG

  • (IgG is only class that is opsonizing for phagocyte, which have receptors for Fc of IgG)
  • Helps other cells Gobble up bacteria (opsonizing)
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10
Q

The most common immunodeficient disease is being able to not make enough of which Ig?

A

IgA

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11
Q

In mature B cells, the antigen receptor normally consists of which two isotypes?

A

IgM and IgD

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12
Q

Which part of IgE adheres to mast cells and basophils?

A

Fc of IgE

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13
Q

main inflammatory mediator of the humoral immune system.

A

Complement

- remember, Humoral is an antibody mediated response

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14
Q

Three ways to activate complement © cascade, C3.

And whether it is part of innate or adaptive immunity.

A

§ Classical: adaptive
§ Alternative: innate
§ Lectin: innate

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15
Q

In adaptive immune system what triggers complement

A

antibodies

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16
Q

Innate immune system what triggers complement

A

Substances on surfaces of pathogens (not antibody)

-remember: PAMPs and DAMPs

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17
Q

Which way is complement activated by IgG and IgM?

A

via classical pathway (adaptive)

require antibodies → trigger complement

18
Q

Classical complement activation pathway

A

Bacteria invaders identified → antibodies trigger
classical pathway activated by complexes of IgG or IgM antibody with antigen →
C1q must interact with the 2 Fcs simultaneously →
C1 activates C4 then C2 → C4b2a together activate C3 →C4b2a3b together activate C5-C6-C7-C8-C9

19
Q

Alternative complement activation pathway

A

Bacteria cell wall structures →
activate complement (absent of antibody) →
C3 break down to C3a and C3b →
C3b binds to cell wall anchor, properdin (P), located on bacteria cell wall structure →
Normal rapid degradation of C3b halted and stabilized →
Anchor allows for assembly of C3b, factor B, and Factor D →
C3bDbC3b (trimer of Db and 2 C3b units) → activates C5 → C6-7-8-9

20
Q

What bacterial infect may indicate a defect in the C3b-C8 pathway?

A

Neisseria(ie gonorrhea, a Gram-negative coccus):

  • resistant to lysis by C9 (which is necessary for their clearance)
21
Q

Two mechanisms for red cell destruction (hemolysis)

A

Intravascular hemolysis

Extravascular hemolysis

22
Q

Intravascular hemolysis

A

RBC basically explodes in vessel → Releases Hb into circulation → dissociate into αβ dimer → bind to haptoglobin →circulated haptoglobin/Hb removed by liver

23
Q

How can methemoglobin result from intravascular hemolysis?

A

RBC basically explodes in vessel → Releases Hb into circulation → Iron can be oxidized (Fe3+) → methemoglobin (cannot bind O2)

24
Q

What does the presence of metheme and Hb in your urine indicate? What does free metheme bind to?

A

intravascular hemolysis

Metheme binds to albumin → taken to liver

25
Q

Extravascular hemolysis (90% of all hemolysis)

A

RBC trapped in spleen is ingested by macrophages of RE system →
releases blood components
→ Heme (w/ porphyrin ring) separate from globin →
iron removed → stored in ferritin →
porphyrin ring converted to bilirubin → released from cell → conjugated in liver via glucuronide conjugation→
excreted into bile duct → Small intestine →
converted to urobilinogen →
excreted in feces or filtered and excreted by kidneys

26
Q

Will you expect to see high or low levels of bilirubin with intravascular hemolysis?

A

High

that free porphyrin ring man!

27
Q

Would you expect to see high or low levels of haptoglobin with intravascular hemolysis?

A

Low

28
Q

What are the clinical symptoms and signs of Hereditary spherocytosis?

A

Anemia, jaundice, splenomegaly, hyperbilirubinemia as neonates

can lead to aplastic crisis and biliary stones

29
Q

Would you expect to see high or low levels of bilirubin in hereditary spherocytosis? Why?

A

High - RBC rupturing->released hb converted to unconjugated bili-> high bili

can lead to gallstones

30
Q

How does G6P Deficiency → hemolysis?

A

Premature loss of G-6-PD activity → oxidation of hemoglobin → denatured globin attaches to membrane (Heinz bodies) → spectrin gets oxidized → RBC less deformable → trapping in spleen →extravascular hemolysis

31
Q

Major foods, drugs, or other chemicals which can induce hemolytic anemia in patients with G6PD deficiency.

A
  • Aspirin
    • Fava beans
    • Legumes
    • Methylene blue (for methemoglobinemia- remember?),
    • Vitamins C and K.
32
Q

Direct Coombs test / Direct antiglobulin test (DAT):

A

Evaluates presence of IgG or complements on surface of Pt’s RBCs (not serum)

• Autoimmune hemolytic anemia = (+) DAT

33
Q

Indirect Coombs test / Indirect antiglobulin test:

A

Evaluates if Pt’s serum (not RBCs) can bind IgG or complement

34
Q

Cold antibodies:

  1. Which Ig?
  2. Intravascular or extravascular?
A
  1. IgM
  2. Intravascular

I M COLD so i want to be INside

35
Q

Warm antibodies:

  1. Which Ig?
  2. Intravascular or extravascular?
A
  1. IgG

2. Extravascular

36
Q

Cells of adaptive immunity

A

B and T lymphocytes

APCs

37
Q

Innate immunity

A

Toll like receptors recognize PAMPs and DAMPs

Absence of normal cell surface molecules recognized by NK cells

38
Q

Which Immunoglobulins are involved in classical complement activation

A

IgM and IgG

General Motors make Classical cars

39
Q

which immunoglobulin is most abundant in plasma?

A

IgG

  • present in Great amounts
40
Q

Distinguish between actions of Cold and Warm antibodies and how they can induce AIHA

A

Cold: Transiently bind RBCs → activates complements to lyse them

Warm: Bind strongly to RBC →Spleen → activate macrophages → destroy bounded RBCs

TT BL and DD Exam1 (23 decks)

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