CLS 790 Serology Quiz #2 Flashcards
Immunofixation Electrophoresis
Serum run on different rows of gel, anti-antibodies used to see each type of immunoglobulins in each row
Titer results
Dilution factor of last dilution that shows positive result
Prozone
More antibodies than antigen
Post-zone
More antigen than antibody
Zone of equivalence
Antigen and antibody concentrations close enough to form immune complexes
Precipitation assays
soluble antigen reacts with soluble antibody (turbidity/nephelometry)
Ouchterlony formation patterns
Identity: solid bent line between antibody, unkown antigen, and standard antigen
Non-identity: crossed lines, little similarity between standard and unkown antigen
Partial identity: lines close but obviously distinct, standard and unknown antigen have similar epitopes
Radial immunodiffusion
Agar has antibody in it, patient sample added to well, allowed to difuse
Ring is formed, diameter of ring is proportional to concentration
Immunoelectrophoresis
Antigens run on gel first, trough cut and antibody added which diffuses
Hypogammaglobulinemia
Low amounts of Ig’s
A-gammaglobulinemia
Absence of Ig’s
Hypergammopathy
Too many Ig’s
Direct agglutination
Antigen directly combines with antibody
Indirect agglutination
Carrier molecule coated with antigen, reacts with antibody in more visible way
Hemmaglutination
ABO blood group assay
Flocculation test
Precipitate of fine particles, use indirect method
Complement fixation test
No hemolysis = complement reacted with Ag/Ab complex (Ab is present in patient)
Hemolysis = complement not fixed onto Ag/Ab complex, no Ab in patient
Western Blot
Proteins, using electrophoresis the use anti-protein antibody
Southern Blot
DNA, using electrophoresis and radioisotopes
Heterophile antibodies
IgM’s produced in infection that are capable of binding to unrelated antigens from other species
Forssman antibody
Antibody developed during mono infection also reacts against guinea pig kidney and sheep RBC
Heterophile antibody tests
Paul Bunnell, Dadisohn Differential
Toxoplasma gondii
Asymptomatic to mono-like symptoms (birth defects cause hydrocephalus)
Domestic cat is host, difficult to culture, use EIA to test
Nontreponemal tests
Venereal Disease Research Laboratory (VDRL) and Rapid plasma reagin (RPR)
VDRL test
Looking for flocculation on slide, can do quantitative to monitor treatment, CSF can only be tested via VDRL
ANA test
Screening test for autoantibody reactivity
Homogenous ANA pattern usually indicative of:
SLE (systemic lupus erythamatosus)
Centromere (discrete speckled) ANA pattern usually indicative of:
Scleroderma (CREST)
Speckled ANA pattern usually indicative of:
Sjogren syndrom
Nucleolar ANA pattern usually indicative of:
Scleroderma
SLE clinical presentation
Multi-organ involvement (skin, joints, kidney, lungs, CNS), non-deforming arthritis, Raynaud’s, butterfly rash, anemia, decreased platelets, increased erythrocyte sedimentation rate
Drug-induced SLE
Has antibodies to histones but not to ds-DNA, shows positive on ANA but negative on Crithidia lucilae
Crithidia lucilae
Single cell protozoan, has mitochondrial mass of ds-DNA, SLE antibodies react
SLE antibodies
Anti-dsDNA and anti-Smith
Sjogren’s Syndrome clinical presentation
Affects lacrimal and salivary glands (dry eyes and mouth, pain and swelling in glands)
Sjogren’s Syndrome antibodies
Anti-La, rheumatoid factor (need biobsy of salivary glands for definitive diagnosis)
Scleroderma 2 forms
Progressive diffuse, systemic CREST
CREST meaning
Calcinosis (bone formation) Raynaud Esophogeal involvment Sclerodactyly (hard fingers) Telangiectasia (spider veins)
Scleroderma clinical presentation
Cyanosis, puffy face, hard skin, GI symptoms, lung and heart arrythmias
Scleroderma antibodies
Anti-centromere
Insulin-dependent Diabetes Mellitus antibodies
Anti-beta cells, can’t produce insulin
MIXED Connective tissue disease clinical presentation
Joint pain, stiffness, esophageal disfunction, progressively worsening, leukopenia, arthritis
MIXED Connective tissue disease antibodies
Anti-ssDNA
Rheumatoid arthritis clinical presentation
Joint swelling, morning stiffness, weight loss, fatigue, low grade fever
Rheumatoid arthritis antibodies
Rheumatoid factor (IgG, IgM, IgA)
Autoimmune hepatitis antibodies
Anti-liver smooth muscle
Goodpasture’s disease antibodies
Anti-glomerular basement membrane
Pernicious anemia antibodies
Anti-parietal cell
Hashimoto’s Thyroiditis
Increased TSH, normal T3/T4, hypothyroidism
Grave’s disease
Increased T3/T4, decreased TSH, hyperthyroidism
Pernicious anemia clinical signs
Can’t absorb vitamin B12 due to destruction of parietal cells in GI, inability to secret HCl, and intrinsic factor (IF)
Autoimmune liver disease antibodies
Anti-liver soluble protein
Anti-liver membrane
Anti-acidoglycoprotein receptor
Nephelometry
Measuring light scattering off of Ag/Ab complexes, more scattered light means more complexes
Liver disease
Non-infectious inflammation in the bile ducts, disease manifests initially as a painless jaundice with itching. Progresses to ductal occlusion, results in cirrhosis, end stage liver failure
What type of patterns are seen in ANAs of liver disease?
mixture of speckled, homogenous, anticentromic, nuclear membrane patterns
Who is mainly affected by pernicious anemia?
Elderly females
What is the treatment for pernicious anemia?
injections of B12
What are the signs of Grave’s disease?
Enlargement of the thyroid, tachycardia, bulging eyes, weight loss
What does ANA test react with?
nuclear DNA/RNA of substrate cells
What cells does ANA test use?
HEp-2 cells at different stages of mitosis react that with the patient’s anti-nuclear antibody
What is an example of a sandwich test?
ANA test
What do Hemagglutination
tests use?
RBCs (viral test)
What is Double Immunodiffusion Assay used for?
detecting antibodies associated with autoimmune disorders
In Goodpasture’s syndrome, what happens when there’s presence of autoantibody to the glomerular basement membranes?
Results in injury to the glomerulus that progresses rapidly to renal failure
In SLE, what is the cause of tissue damage?
Tissue damage is due to ab/ag complexes in the renal glomeruli, skin, and choroid plexus of the brain.
How do you distinguish MIXED connective tissue disease from SLE?
MIXED connective tissue disease does NOT have multiple anti-SM and anti-ds-DNA antibodies
One of the only autoimmune diseases that affects more males than females
Anklyosing spondylitis
What cells secrete IgG rhematoid factor?
Plasma cells
What does RA latex agglutination most detect?
IgM rheumatoid factor
What is the difference between organ-specific and systemic autoimmune disorders?
- Systemetic = a series of organs affected
- Organ-specific = affects just one organ
What are the 4 organ-specific autoimmune diseases?
- Hashimoto’s thyroiditis
- Grave’s disease
- GI tract disease
- Liver disease
What are systemic autoimmune disorders?
- SLE
- Sjogren’s syndrome
What is Raynaud’s syndrome?
cyanosis on cold temperatures; stress-induced vasoconstriction
Has also been associated with the antinuclear antibody conditions (RNP)