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IMSE LABORATORY > FIANLS - ANA - DETECTIO OF ANTI-NUCLEAR ANTIBODIES > Flashcards

FIANLS - ANA - DETECTIO OF ANTI-NUCLEAR ANTIBODIES Flashcards

1
Q

materials used for ana

A

sle latex suspension
positive and negative control
black test cards
mechanical rotator
disposable stirrers

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2
Q

procedure

A

add 1 drop of SLE latex reagent to each sample on the black test card
mix the flat end of the pipette or mixer and spread the fluid evenly covering the entire diameter of the test circle.
tilt the slide back and forth slowly for 3 minutes while observing for agglutination
observe and interpret the results

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3
Q

principle of the test

A

ELISA and CLIA - automated pocess

ELISA and CLIA are assays that can test from a broad range of antibodies if multiple nuclear antigens are coated onto a single test well, or for specific ANAs if each well is coated with a single antigen. These antigens used in commercial kits are derived from tissue extracts or produced by recombinant technology. Because of their advantages, man laboratories are using ELISA methods to screen for presence of ANAs in addition to identifying specific ANAs

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4
Q

ELISA means

A

enzyme-linked immunosorbent assay

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5
Q

CLIA means

A

Chemiluminescence Immunoassay

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6
Q

is sensitivity of ELISA depends on the machine and the manufacturer?

A

yes

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7
Q

one study found that the sensitivity of ELISA assay is ranging from __ to ___ and specificity from ___ to ___ when they were compared with IIF ana method

A

sensitivity- 69% to 98%
specific - 81% - 98%

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8
Q

what do we look for if we’re conducting a qualitative test/

A

agglutination

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9
Q

do we need to bring all the reagents first to room temp before using

A

yes, then mix gently prior to use

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10
Q

it indicates a positive result

A

agglutination

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11
Q

the positive sera must show distinct agglutination within __mns

A

3 mns

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12
Q

agglutination indicates the level of ___in the range commonly found in the SLE

A

antinuclear antibody (especially anti dnp)

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13
Q

findings in the sensitivity studies suggest that immunoassays miss a significant proportion of ____ and also yield a significant number of false positive results.___

A

ANA-positive patients; false positive results

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14
Q

based on such studies, the ACR has recommended that the ___remains the gold standard for ANA testing and that clinical laboratories should specify the method they use when they are reporting the result.

A

IIF test - indirect immunofluorescent test

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15
Q

is a chronic systemic inflammatory disease that affects people usually at the peak age between 20 - 40

A

systemic lupus erythematosus

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16
Q

is ANA a confirmatory test?

A

nope

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17
Q

ANA can be detected in multiple auto immune disease, so it’s not ___

A

specific

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18
Q

SLE is at peak at ages ___

A

20 - 40

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19
Q

what gender is most likely to be affected by SLE

A

women

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20
Q

ratio of how women are most likely to be affected by SLE than men

A

9:1

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21
Q

this auto immune disease appears to originate from complex interaction between several factors, such as ___

A

environmental, genetic susceptibility, and abnormalities within the immune system

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22
Q

over ___ autoantibodies associated with SLE have been discovered

A

100

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23
Q

among the 100 auto antibodies found in SLE,

it include

A

double stranded DNA (ds DNA), histones, and other nuclear components,

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24
Q

among the 100 sle antibodies, there are auto antibodies to formed elements such as

A

erythrocytes, and platelets, as well as other body components such as phospholipids, ribosomal components and endothelium

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25
Q

laboratory diagnosis of SLE include ___

A

CBC, platelet count and urinalysis

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26
Q

findings in Lupus patients are ___

A

leukopenia, and possible anemia, and thrombocytopenia.

27
Q

esr in SLE may be ___ even though C reactive protein tends to be low or normal

A

elevated

28
Q

the most specific antibodie for SLE

A

double stranded DNA

29
Q

when SLE is suspected, the first test typically done is a screening test for __

A

anti-nuclear antibodies

30
Q

these antibodies are present in most cases of SLE, antibodies that are directed against antigens of nuclei of mammalian cells

true or false

A

true

31
Q

ana’s are present in over __ of patients with active SLE and is used as a major marker for the disease

A

95%

32
Q

ANAs are not specific only to SLE as it may be present in other connective tissue disease such as ___, ___, _, and ___

A

Sjogren’s syndrome, scleroderma, polymyositis-dermatomyositis, and RA

33
Q

ANAs, they can also be found in some individuals with other conditions including ___

A

chronic infections, pregnancy, ad cancer.

34
Q

up to ___of healthy individuals is positive to ana

A

5%

35
Q

up to ___of elderly people are positive to ANA

A

30%

36
Q

ANAs are ____ group of antibodies that have different antigen specificities

(heterogenous, homogenous)

A

heterogenous

37
Q

The nuclear antigens they are directed against include ____

A

double or single stranded DNA, histones nucleosomes, centromere proteins, ad extractable nuclear antigens

38
Q

why do double stranded dna antibodies are the most specific for SLE?

A

becoz they are mainly seen in patients with lupus and their levels correlate with disease activity,

39
Q

antibodies to dsDNA typically produce a ___ staining pattern on indirect immunofluorescence

A

peripheral or homogenous

40
Q

methods in detecting ANA have been developed. These include ___

A

FANA or indirect immunofluorescent assay,
immunoperoxidase staining
enzyme linked immunoabsorbent assay
microsphere multiplex immunoassays
radioimmunoassay
immunodiffusion
immunoblottng (western blot)
dot blot
immunoelecterophoresis
microarray

41
Q

what is the staining pattern in IIF of SLE

A

peripheral, homogenous,speckled, and nucleolar

42
Q

if SLE only, the staining pattern is

A

peripheral

43
Q

antibodies found in peripheral

A

anti DNA
not seen on HEp - 2

44
Q

antibodies found in homogenous or diffuse staining pattern of IIF

A

anti - dna
anti - histone
anti DNP (nucleosome)

45
Q

disease associated with homogenous pattern staining of IIF

A

RA
SLE
Miscellanous disorders (anti ss dna)

46
Q

antibodies found in speckled pattern of IIF

A

anti sm & rnp
anti ro and la
anti - jo - 1 and mi 2
anti sci 70

47
Q

diseases associated with speckled pattern staining in IIF

A

sle and ss
pm/dm
pss (systemic)

48
Q

antibody found in centromere staining pattern in IIF

A

anti centromere

49
Q

disease associated to centromere pattern in IIF

A

pss (crest)

50
Q

anti body found in nucleolar staining in IIF

A

ANTI NUCLEOLAR

51
Q

DISEASES found in nucleolar staining in IIF

A

sle and pss

52
Q

the limited symptoms of scleroderma is referred to as

A

crest

53
Q

transcribe crest

c

A

calcinosis

54
Q

transcribe crest

r

A

raynaud’s phenomenon

55
Q

transcribe crest

E

A

esophageal dysfunction

56
Q

transcribe crest

S

A

sclerodactyly

57
Q

transcribe crest

T

A

telangiectasis

58
Q

refers to the calcium deposited in the skin

A

calcinosis

59
Q

spasm of blood vessels in response to cold or stress

A

raynaud’s phenomenon

60
Q

acid reflux and decrease in motility of esophagus

A

esophageal dysfunction

61
Q

thickening and tightening of the skin in the fingers and hands

A

sclerodactyly

62
Q

dilation of capillaries causing red marks on surface of the skin

A

telangiectasias

63
Q
A

IMSE LABORATORY (8 decks)

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