FIANLS - ANA - DETECTIO OF ANTI-NUCLEAR ANTIBODIES

Question 1

materials used for ana

Answer 1

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

Question 2

procedure

Answer 2

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

Question 3

principle of the test

Answer 3

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

Question 4

ELISA means

Answer 4

enzyme-linked immunosorbent assay

Question 5

CLIA means

Answer 5

Chemiluminescence Immunoassay

Question 6

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

Answer 6

yes

Question 7

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

Answer 7

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

Question 8

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

Answer 8

agglutination

Question 9

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

Answer 9

yes, then mix gently prior to use

Question 10

it indicates a positive result

Answer 10

agglutination

Question 11

the positive sera must show distinct agglutination within __mns

Answer 11

3 mns

Question 12

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

Answer 12

antinuclear antibody (especially anti dnp)

Question 13

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

Answer 13

ANA-positive patients; false positive results

Question 14

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.

Answer 14

IIF test - indirect immunofluorescent test

Question 15

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

Answer 15

systemic lupus erythematosus

Question 16

is ANA a confirmatory test?

Answer 16

nope

Question 17

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

Answer 17

specific

Question 18

SLE is at peak at ages ___

Answer 18

20 - 40

Question 19

what gender is most likely to be affected by SLE

Answer 19

women

Question 20

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

Answer 20

9:1

Question 21

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

Answer 21

environmental, genetic susceptibility, and abnormalities within the immune system

Question 22

over ___ autoantibodies associated with SLE have been discovered

Answer 22

100

Question 23

among the 100 auto antibodies found in SLE,

it include

Answer 23

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

Question 24

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

Answer 24

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

Question 25

laboratory diagnosis of SLE include ___

Answer 25

CBC, platelet count and urinalysis

Question 26

findings in Lupus patients are ___

Answer 26

leukopenia, and possible anemia, and thrombocytopenia.

Question 27

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

Answer 27

elevated

Question 28

the most specific antibodie for SLE

Answer 28

double stranded DNA

Question 29

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

Answer 29

anti-nuclear antibodies

Question 30

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

Answer 30

true

Question 31

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

Answer 31

95%

Question 32

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

Answer 32

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

Question 33

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

Answer 33

chronic infections, pregnancy, ad cancer.

Question 34

up to ___of healthy individuals is positive to ana

Answer 34

5%

Question 35

up to ___of elderly people are positive to ANA

Answer 35

30%

Question 36

ANAs are ____ group of antibodies that have different antigen specificities (heterogenous, homogenous)

Answer 36

heterogenous

Question 37

The nuclear antigens they are directed against include ____

Answer 37

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

Question 38

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

Answer 38

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

Question 39

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

Answer 39

peripheral or homogenous

Question 40

methods in detecting ANA have been developed. These include ___

Answer 40

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

Question 41

what is the staining pattern in IIF of SLE

Answer 41

peripheral, homogenous,speckled, and nucleolar

Question 42

if SLE only, the staining pattern is

Answer 42

peripheral

Question 43

antibodies found in peripheral

Answer 43

anti DNA not seen on HEp - 2

Question 44

antibodies found in homogenous or diffuse staining pattern of IIF

Answer 44

anti - dna anti - histone anti DNP (nucleosome)

Question 45

disease associated with homogenous pattern staining of IIF

Answer 45

RA SLE Miscellanous disorders (anti ss dna)

Question 46

antibodies found in speckled pattern of IIF

Answer 46

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

Question 47

diseases associated with speckled pattern staining in IIF

Answer 47

sle and ss pm/dm pss (systemic)

Question 48

antibody found in centromere staining pattern in IIF

Answer 48

anti centromere

Question 49

disease associated to centromere pattern in IIF

Answer 49

pss (crest)

Question 50

anti body found in nucleolar staining in IIF

Answer 50

ANTI NUCLEOLAR

Question 51

DISEASES found in nucleolar staining in IIF

Answer 51

sle and pss

Question 52

the limited symptoms of scleroderma is referred to as

Answer 52

crest

Question 53

transcribe crest c

Answer 53

calcinosis

Question 54

transcribe crest r

Answer 54

raynaud's phenomenon

Question 55

transcribe crest E

Answer 55

esophageal dysfunction

Question 56

transcribe crest S

Answer 56

sclerodactyly

Question 57

transcribe crest T

Answer 57

telangiectasis

Question 58

refers to the calcium deposited in the skin

Answer 58

calcinosis

Question 59

spasm of blood vessels in response to cold or stress

Answer 59

raynaud's phenomenon

Question 60

acid reflux and decrease in motility of esophagus

Answer 60

esophageal dysfunction

Question 61

thickening and tightening of the skin in the fingers and hands

Answer 61

sclerodactyly

Question 62

dilation of capillaries causing red marks on surface of the skin

Answer 62

telangiectasias