Chapter 3: Immunologic Diseases and Conditions: Diagnosis

Question 1

What is the diagnosis of Acquired immunodeficiency Syndrome (AIDS)

Answer 1

enzyme-linked immuosorbent assay (ELISA), western blot test, HIV antibody testing

Question 2

What is the diagnosis of Common Variable immunodeficiency (Acquired Hypogammaglobulinemia)

Answer 2

history of chronic infections; hypogammaglobulinemia (IgA, IgM); immune response to vaccine

Question 3

What is the diagnosis of Selective Immunoglobulin A Deficiency

Answer 3

recurrent sinopulmonary infections, IgA deficiency, diagnosis not defininite until after age 4

Question 4

What is the diagnosis of X-linked Agammaglobulinemia

Answer 4

family history of death from infections; immunoelectrophoresis

Question 5

What is the diagnosis of Severe Combined Immunodeficiency

Answer 5

newborn screening; clinical picture; lymphopenia (T-cells), absense of thymic shadow on chest radiograph

Question 6

What is the diagnosis of DiGeorge’s Anomaly (Thymic Hypoplasia or Aplasia)

Answer 6

reduced T-cells; 2 of following 3: cardiovascular defects, hypocalcemia (3 weeks), microdeletion involving 22 chromosome; abnormal thymus gland

Question 7

What is the diagnosis of Chronic Mucocutaneous Candidiasis

Answer 7

recurrent candida infections; lesion scrapings show yeast pseudohyphae; bad response to candida

Question 8

What is the diagnosis of Wiskott-Aldrich Syndrome

Answer 8

boy with thrombocytopenia & small platelet size; eczema, frequent infections; mutation of WASP

Question 9

What is the diagnosis of Autoimmune Hemolytic Anemia

Answer 9

Coombs’ test; RBCs appear spherical; raised serum-bilirubin levels; hematocrit and RBC tests decreased; reticulocyte count raised;

Question 10

What is the diagnosis of Pernicous Anemia

Answer 10

CBC analysis, peripheral blood smear; longer bleed time, reduced platelet count, malformed platelets; exclude all other possible diseases

Question 11

What is the diagnosis of Idiopathic Thrombocytopenia Purpura

Answer 11

complete blood count analysis, peripheral blood smear; longer bleed time, reduced platelet count, malformed platelets; exclude other diseases

Question 12

What is the diagnosis of Immune Neutropenia

Answer 12

significantly reduced neutrophils; neutrophil antibodies detected with immunofluoresence & agglutination tests

Question 13

What is the diagnosis of Goodpasture’s Syndrome

Answer 13

suspected with acute glomerulonephritis; anti-GBM antibodies in serum found with ELISA, immunoflorecense, renal biopsy

Question 14

What is the diagnosis of Systemic Lupus Erythematosus

Answer 14

4 or more of following: butterfly rash, discoid skin lesion, photosensitivity, nasopharyngeal ulceration, polyarthritis, seizures/psychosis, chronic pleuritis/pericarditis, cellular cysts in urine, abnormal antibodies in bloodstream, LE cells

Question 15

What is the diagnosis of Scleroderma (Systemic Sclerosis)

Answer 15

complete history & physical examination; centromere antibodies found, blood tests and urinalysis

Question 16

What is the diagnosis of Sjorgren’s Syndrome

Answer 16

Schirmer testing for dry eyes; lower lip biopsy indicates infiltration of lymphocytes; decreased WBC count, anemia, autoantibodies

Question 17

What is the diagnosis of Rheumatoid Arthritis

Answer 17

elevated rheumatoid factor in blood; CBC, synovial fluid analysis; serum protein electrophoresis

Question 18

What is the diagnosis of Juvenile Rheumatoid Arthritis

Answer 18

history and physical examination, blood tests for rheumatoid factor; IBD, psoriatic arthritis are also types

Question 19

What is the diagnosis of Ankylosing Spondylitis

Answer 19

family history; neg RF; HLA-B27 present in most; x-ray finds sacroiliitis, “squaring” of vertebrae, joint fusion, osteoporosis

Question 20

What is the diagnosis of Polymyositis

Answer 20

look for other muscle conditions (MD); accompany certain cancers; Elevated muscle enzymes; EMG shows typical abnormal pattern of electrical activity in inflamed muscle

Question 21

What is the diagnosis of Multiple Sclerosis

Answer 21

physical examination; eliminated other causes of S&S; two or more CNS dysfunctions; cerebral or spinal plaque is found; elevated immunoglobulin level

Question 22

What is the diagnosis of Myasthenia Gravis

Answer 22

test for fatigability; Tensilon test (short-acting acetylcholine); antibodies against acetylcholine receptor; electromyography

Question 23

What is the diagnosis of Small Vessel Vasculitis

Answer 23

histology and immunofluorescence studies; immunoglobulins present, bleeding disorders; bleeding disorders and aspirin can cause skin to mimic

Question 24

What is the diagnosis of Systemic Necrotizing Vasculitis

Answer 24

complete history and physical examination; CBC-anemia, increase WBC; ESR-elevated; RA factor determination; biopsy confirms diagnosis-invasion of leukocytes in blood; angiogram of vessels