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ACAAI Review 3rd Edition > Ch. 8 Specific Diagnostic Modalities > Flashcards

Ch. 8 Specific Diagnostic Modalities Flashcards

1
Q

polymorphism in which chemokine are associated with serum total IgE?

A

CCL-11 (eotaxin) - increased in blacks, decreased in whites

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2
Q

venom IDTs are performed up to what concentration?

A

1 ug/mL

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3
Q

nasal responsiveness to capsaicin is increased in what condition?

A

allergic rhinitis (not in non-allergic)

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4
Q

both histamine and methacholine induce a secretory response, but unlike histamine, methacholine does not induce?

A

nasal reflexes

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5
Q

what is the most reproducible measurement in pulmonary function test?

A

FEV1

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6
Q

what is the primary outcome measure in most FDA phase III asthma drug trials?

A

FEV1

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7
Q

what is considered a significant response to bronchodilator?

A

increase of FEV1 of 12% AND increase of 200mL

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8
Q

T or F, severity of airway hyper responsiveness does not correlate with severity of asthma

A

TRUE

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9
Q

what is the difference between selective and non-selective bronchoprovacation?

A

selective testing looks at specific triggers, non selective testing produces bronchoconstriction in all asthmatic

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10
Q

is methacholine a direct or indirect bronchonconstrictor?

A

direct

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11
Q

what PC20 concentration is considered positive?

A

PC20 < or equal to 8mg/ml

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12
Q

T or F, a negative methacholine challenge in the winter excludes seasonal pollen induced asthma?

A

FALSE

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13
Q

what are the indirect bronchoconstrictors?

A

exercise, hypertonic saline, cold, mannitol, adenosine, allergen

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14
Q

which bronchoprovocation test is highly sensitive? specific?

A

sensitive: methacholine
specific: mannitol, exercise

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15
Q

mucus is increased in asthmatic, which gene is expressed more in asthmatics compared to normal controls?

A

mucin gene (MUC5AC)

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16
Q

who gets more airway infections, primary ciliary dyskinesia patients or CF?

A

CF - suggests that altered mucus plays larger role in disease progression than ciliary movement

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17
Q

what method is used to quantify IgG, IgA, IgM, and inflammatory markers?

A

nephelometry

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18
Q

what method to determine the presence of allergen specific IgE, BNP, complement, toxins, histamine, leukotriene C4, and tumor markers?

A

ELISA

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19
Q

western blot procedure?

A

separate proteins on gel, transfer to a membrane, then add specific antibody followed by a secondary antibody conjugated to an enzyme, measure the colorimetric reaction

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20
Q

What diseases are confirmed by Western blot?

A

HIV and Hep B

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21
Q

what is the process of immunofixation electrophoresis

A

separate serum proteins on gel, expose to specific anti-sera and the immunoprecipitate is visualized with a protein stain

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22
Q

immunoCAP uses what method to detect allergen specific IgE?

A

ELISA – sandwich assay

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23
Q

allergen IgE determined from Immunocap, Turbo MP and Immulite 200 are NOT comparable. Studies determining predictive values of specific IgE for food is determined by which one?

A

immunocap

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24
Q

immunofixation electrophoresis is used for?

A

identification and quantification of monoclonal paraproteins seen on SPEP, and determine which light chain is present

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25
Q

zone of equivalence results in small or large immune complexes?

A

large

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26
Q

zone of antigen excess or antibody excess produces small or large immune complexes?

A

small

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27
Q

descending order of complement activation by immunoglobulin?

A

IgM > IgG3 > IgG1 > IgG2

28
Q

excessive immune complex formation results in complement consumption, so what levels can be used to monitor disease activity?

A

C3, C4 (e.g. in SLE)

29
Q

what assays are used to measure cytokines and mediators?

A

ELISA or RIA assays

30
Q

forward scatter on flow cytometry measures?

31
Q

side scatter on flow cytometr measures?

A

granularity and complexity

32
Q

what monoclonal antibody is used in the treatment of solid organ transplant rejection and acute T cell ALL?

A

OKT3 - monoclonal anti-CD3

leads to activation then apoptosis of T cells causing immunosuppression

33
Q

what is the proposed mechanism of IVIG?

A

binding of FcyRIIb

34
Q

increased number of B cells with low levels of this CD marker are associated with CVID?

A

high levels of CD-21 low B cells

35
Q

what CD markers are measured after an abnormal newborn screen for TRECs?

A

CD45RO and CD45RA, there are low levels of CD45RA in SCID

36
Q

CD4 expression is down regulated by which HIV protein?

37
Q

HIV binds to what CD marker as a correceptor for entry into T cells?

38
Q

where does omalizumab bind on free IgE?

A

CH3 domain of free IgE, specifically at the FcERI binding site

39
Q

what is the most potent complement receptor?

A

CR3 which binds iC3b

40
Q

hereditary C3 deficiency presents with?

A

autoimmune disease and recurrent infections

41
Q

which chemokine receptors are co-receptors for HIV entry?

A

CCR5, CXCR4

42
Q

how does the DHR test work?

A

DHR is taken up by phagocytes and oxidized to a green fluorescent compound by products of the NADPH oxidase system, fluorescence is measured by flow cytometry

43
Q

AH50 measures lysis of alternative pathway by lysing what RBCs?

A

unsensitized rabbit RBCs

44
Q

CH50 measures lysis of complement pathway by lysing what RBCs?

A

sheep RBCs sensitized with rabbit IgM

45
Q

the most common cause of low complement level?

A

poorly handled specimen, always repeat abnormal test

46
Q

hybridomas are made of what two cells?

A

spleen cells from an immunized mouse fused with myeloma cells that lack Ab production and HGPRT

47
Q

ximab means?

A

chimeric -mouse and human

48
Q

umab

49
Q

zumab

50
Q

omab

51
Q

what method should be used in patients with antibody deficiencies to detect infections?

52
Q

Besides SCID, what other conditions can have low TREC levels in newborns?

A

HIV, Down syndrome, and 22q11 deletion

53
Q

what can nex-gen sequencing be used for?

A

whole exome sequencing, screening panels of disease-related genes, transcription factor binding sites, DNA methylation patterns, and metagenomics (studies microbial DNA populations)

54
Q

southern blot detects?

55
Q

western blot detects?

56
Q

northern blot detects?

57
Q

what can be diagnosed using FISH

A

22q11.2 deletion, Prader Willi, Angelman, Cri–du-chat, Down syndrome, ALL

58
Q

microarray use what substrate and rely on what luminescence for detection?

A

substrate: glass, silicone, or polystyrene beads

use fluorescence for detection

59
Q

microarrays can be used to detect?

A

gene expression patterns, SNPs, chromosomal abnormalities, genotype mutations

60
Q

how do microarrays work?

A

known cDNA probes are present on microarray chip, RNA from patient is reverse transcribed to cDNA, which is amplified by PCR and labeled, the cDNA then hybridizes to microarray cDNA probes and the intensity of the fluorescence is measured to determine gene expression

61
Q

what alleles are matched for SCT?

A

HLA-A, B, C, DRB1, and DQB1

62
Q

what alleles are matched for solid organ?

A

HLA-A, B, DR

63
Q

what solid organs are usually NOT matched for HLA type?

A

heart, liver, lung and pancreatic grafts

64
Q

xray and CT finding in chronic eosinophilic pneumonia?

A

“photonegative” pulmonary edema

peripheral, non segmental opacities in middle and upper lung zones

65
Q

CT findings in GPA?

A

peripheral wedge shaped consolidations, multiple nodules, some with cavitation

66
Q

a pneumatocele on CT should make you think of what condition?

A

STAT 3 hyper IgE syndrome

67
Q

absent thymic shadow indicates?

A

complete Digeorge

ACAAI Review 3rd Edition (9 decks)

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