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foundations. exam 2 > clinical immunology > Flashcards

clinical immunology Flashcards

1
Q

which antibody appears first in the primary immune response

A

IgM

“mom comes first”

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2
Q

which antibody appears second during a primary immune response

A

IgG around day 10

“grandma comes next:

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3
Q

IgG synthesis occurs ____ in the secondary immune response compared to the primary immune response

A

early, final concentration is also higher than in the primary response

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4
Q

using antibodies as treatment

A

we can provide artificial passive immunity to a patient by administering immunoglobulins

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5
Q

passive immunity natural example

A

maternal antibodies are transferred to fetus the placenta which will remain weeks to months post delivery

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6
Q

artificial immunity example

A

human or horse immunoglobulin specific to a specific toxin or antigen given to a patient can be IM or IV

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7
Q

what is the most like immunoglobulin given during immunoglobulin treatment

A

IgG is the main immunoglobulin, some treatments contain IgG solely

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8
Q

examples of immunoglobulin treatments

A

rabies ig, tetanus ig, hepatitis ig, and RSV ig

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9
Q

immunoglobulin treatments are typically used when there are no _____ or _______ available

A

antibiotic or vaccine

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10
Q

passive immunity (immunoglobulin) is used when

A

the rick of infection is high and the body does not have sufficient time to develop an immune response

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11
Q

passive immunity length

A

immunity is temporary

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12
Q

which type of immunity does a vaccine administration stimulate artificially

A

active immunity

the antigen is administer and it it the own body that develops its own antibodies

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13
Q

length of vaccine immunity

A

active immunity is typically long lasting so it is ideal that a vaccine will be long lasting as well

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14
Q

how is blood type determined

A

by the presence or absence of RBC antigens

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15
Q

RBC antigen types

A

A antigens and B antigens
people may have one, both or neither

Rh antigens are also absent or present

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16
Q

how do we test for blood type?

A

agglutination, this is antibody binding to an antigen on the RBCs causing clumping

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17
Q

type A blood

A

a antigens present

anti-b antibodies are always present

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18
Q

type b blood

A

b antigens present

anti a antibodies are always present

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19
Q

type AB

A

type A and B antigens present

no antibodies present

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20
Q

type O blood

A

neither antigen present

type A and B antibodies present

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21
Q

Rh - individuals

A

antibodies to the Rh antigen are not always present but they can develop if the pt is exposed to RH+ blood
this is called sensitization

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22
Q

when would you type the fetus’ dad’s blood type

A

when the mother is Rh-, to see if the is Rh + (dominant)

if he was positive the mother would bt tested fr antibodies against the Rh antigen

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23
Q

how do test the mother for Rh antibodies

A

indirect combo’s test
draw blood and mix it with Rh+ RBCs
combo’s serum is added to the mixture and will cause angulation if antibodies are present

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24
Q

what if initial Rh antibody test is negative when do you retest

A

28-30 weeks

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25
how is hemolytic diseases of newborns in subsequent pregnancies prevented
immediately after delivery the mom is given RhoGAM
26
what is rhoGAM
an Rh immunoglobulin that sort of neutralizes the RH antigen
27
universal donor
O -
28
- blood types are only compatible
with other - types depending which antigens are present, but can donate to either positive to negative types
29
universal recipient
AB+
30
most common blood type in the US
O+, then A+
31
most rare blood type in the US
AB-
32
in an emergency situation what blood type is given
type O-
33
why is crossmatching done
to identify other minor antigens
34
how do you perform a indirect combos
mix recipients serum with donors RBC add in combos serum check for angulation
35
prick skin testing detects
detects specific IgE antibodies to allergens such as pollen mol pet and food
36
when someone is allergic to something exposure to it causes
B cells to differentiate and produce IgE to the allergen that will later bind to a mast cells
37
once someone has been exposed to an antigen what happens during repeated exposure to the allergen
the mast cell is sensitized by the allergen and causes the release of histamine and other mediators during exposure
38
histamine release causes
the wheel and flare reaction
39
a positive skin prick test results in
wheal and flare reaction, caused by histamine release
40
RAST test is used to
is a blood test that detects specific igE antibodies in a patent's serum
41
RAST method
the known antigen is coupled to a paper disk the patients serum is added if IgE antibodies are present in the patients serum they will bind to the antigen and test result will be positive additionally radio labeled anti-IgE antibody is added and the radioactive anti IgE binds to the specific IgE (if it is present) and then the radio active emissions are counted
42
big picture of RAST testing
detects IgE antibodies to an allergen | if you are allergic to something then you will produce IgE antibodies against that allergen
43
RAST method big picture
attacks the antibodies with an antigen (the allergen) then marks the IgE with an radioactive anti-IgE antibody then detects the IgE antibody/ anti IgE antibody complex
44
RAST results
``` go from absent to extremely high level of allergen specific IgE measured in (IU/ml) ```
45
window period
if the test detects antibodies there may be a window period where antibodies are not yet being produced against the antigen infection is present but test result is negative
46
should we check for the antigen or antibody in patients that we suspect have HIV
antigen in order to avoid window period and false negative result given to patient, such as with acute HIV, this allows for them to pass on infection (patients are highly contagious during the acute HIV stage)
47
what do the ELISA and Western Blot test for
the presence of antibodies against HIV, but they may be negative during the first few weeks of infection, while antibodies are being produced to a detectable level
48
viral load test
detects the. presence of the virus
49
steps of infectious viral load and antibody
starts with exposures and virus increases until it reaches it's infectious viral load antibody development at this time is low and undetectable and there for would result in a negative result from an antibody detecting test, the patient is still infectious during this time after reaching infectious viral load and will continue until the body is able to produce enough antibody to combat the infectious viral load
50
what does a titer measure
the highest level of dilution in which an antibody still will cause agglutination of an antigen this is not an antigen test
51
why might we use a titer
to see if a treatment has worked, a vaccine is still effective, or to follow the course of an infection
52
is the Rapid Plasma Reagin specific?
not very, but it is very sensitive
53
what does RPR detect?
syphilis
54
what does reagin mean?
the test does not detect antibodies against the actual bacterium but for antibodies against the substances released by cells when they are damaged by T pallidum
55
is RPR specific
no, but is very sensitive
56
RPR decreased titer
results from the body's decreased need to produce as many antibodies used to monitor treatment success example a 1:32 should become 1:4
57
FTA-ABS test
detects antibodies specific to treponema bacterium not detectable until 4-6 weeks after inoculation again sensitive not specific
58
ASO titer
looks for the presence of antisterptolysin O or ASO, which indicates the bod's reaction to group A beta hemolytic strep
59
purpose of ASO titer
primary to determine whether a previous strep infection has caused a post strep disease such as post streptococcal glomerulonephritis
60
enzyme produced by streptococcus organism
sreptollysin O which can lyse red blood cells | it acts as an antigen so the body will produce antibodies to it, antistreptolysin O
61
when does ASO appear in the blood or serum
one week to one month after the onset of infection
62
when are ASO titers the highest | and when will a pts levels return to normal
3 weeks after infections titers are the highest but by 6 months most its titers will have returned to normal
63
using ASO as a diagnostic tool for acute diseases
not useful for diagnosis because many times not enough antibodies are present to be detectable during symptomatic period so instead we use cultures or rapid strep test that find the bacteria or antigen it's self however the it can be useful 2-3 weeks after the onset of infection to diagnosis post strep diseases when a culture is negative because the antigen it's self is no longer present but the antibodies should still be present in this time period
64
HSV IgM antibody production
begins several days are the primary HSV infection | can be detected in the blood from serveral days to several weeks before subsiding
65
HSV gig antibody production
begins after HSV IgM in primary infection concentrations will rise for several weeks then fall and stabilize in the blood where they will continue to make small quantities of HSV igG
66
HSV antibody testing detects
both viral types of herpes simplex virus HSV1 and HSV2 | can detect early IgM antibodies and IgG antibodies that will remain in the system post outbreak
67
culture for HSV uses what bodily fluid
fluid from the blisters, can be painful to pt | this also gives us zero information about whether the disease is primary or recurrent
68
why do we test for IgM and IgG
it helps us distinguish between a primary or recurrent disease and help distinguish from a current/recent infection verses one in the past/ or one that has since resolved
69
Testing for an antigen, positive result
the infecting oraism is present
70
Nucleic Acid Amplification Test (NAATs or NAT0
biochemical technique used to detect the genetic material of an infecting organism help shorten the window period take less time than a culture

foundations. exam 2 (10 decks)

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