immuno1.21.24 Flashcards
Person makes ab, immunized/infection, memoryie. rubella immunization
active immunity
ab transferred to, no memoryie. neonatal syphilitic IgG ab titer
passive immunity
1st line, immediatenonspecific, no memoryskin,acid,PMNs, NK
Natural, innate
Takes timespecific, memoryT/B cells (cytokines,ab)
Adaptive, acquired,anamnastic
Two parts to adaptive, acquired immunity
cellular, humoral
Kind of immunity…viral,fungal, intracellulartcell/lymphokinestype 4 delayed
cellular
type of immunitybacteria,phagocytosis,extracellulartype 1(immediate)type 2(ADCC,complement)type 3 immune complex
humoral
4 things that make antigens more immunogenic
largecomplexprotein/polysaccharideforeign
4 subclasses of IgG
IgG 1,2,3,4
Immunoglobulin with highest concentration
IgG
Concen immunoglobulins high to low
G>A>M>D>E
Largest antibody
IgM
Pentamer, Jchain, fixes complement the best,1st to appear in neonates
igM
Immunoglobulin on mature cells
IgD
Immunoglobulin type 1 hypersensitivity, histamines
IgE
Monoclonal ab made by
immunizing mousecombining spleen cells w/myeloma cells
Hybridoma
plasma cell fused w/myeloma cells,make monoclonal abs
Most circulating lymphoid cells are… and are…%
Tcells, 80%
5 T cell surface markers
CD…2,3,4, 8,25
CD4 surface markers are… and release…
T helper, cytokines
CD3 surface markers are
associated w/TCR
CD2 surface markers
rosette w/SRBCs
2 Tcell surface markers that are regulatory cells that suppress immune response
CD4,25
CD8 is
cytotoxic
3 surface markers on B cells
CD 19,20,21
2 markers for NK cells
CD 16,56
cells that nonspecifically kill virus infected and tumor cells
NK
Normal T:B cell ratio
8:1
Normal T helper:Tcyto ratio
2:1
AIDs T helper:Tcyto
1:2
which pathway initiated by immune complexes (IgG/IgM)
classical
What consists of 21 proteins that controls inflammation, activates phagocytosis, opsonizesEnhances ability of antibody, phagocytic cells to clear microbes/damaged cells, promotes inflammation and attack pathogen cell membrane
complement
In complement what is the major chemotatic agent
C5a
classical complement proteins and order of binding
C: 1,4,2,3
Most abundant complement protein in both pathways
C3
Alternative complement is activated by
lipopolysaccharides, polysaccharidesPathogen surface
Proteins involved in alternative pathway
C3Factors B/D, H/IProperdin
complement proteins of MAC
C56789
Name of soluble ag+ab forms lattice and visibe precipitate forms
precipitation
Double diffusion(ouchterlony),Single diffusion (radial),Immunoelectrophoresis,Immunofixation All are what kinds of rxns
precipitation
antigen excess is called
postzone
antibody excess is called
prozone
IgE mediated, histamine, mast cell activation (Bee sting,hay fever,asthma) all are what type of hypersensitivity rxns
Type 1, anaphylatic, immediate
Complement mediated cytolysis initiated by ag-abTransfusion rxn,AIHA, Hashimoto, Goodpasture all are what type of hypersensitivity rxn
Type 2, ab-dependent cytotoxicity
IgG at soluble ag, immune complexes damage tissueRA, SLE, serum sickness all are what type hypersensitivity
Type 3 immunie complex
Type 2 is
antibody dependent
Type 1 is
anaphylatic, immediate
Type 3 is
immune complex
Type 4 is
delayed
Ag specific Tcell:TB skin tests, contact dermatitis, poison ivy, GVHD all are what type of hypersensitivity
Type 4 delayed
Two skin tests for allergy
RIST,RAST
What test for IgE
ELISA
Eos/IgE in what type of hypersensitivity
Type 1, anaphylatic, immediate
natural active immunity seen in
infection
natural passive immunity seen in
maternal ab
2 primary lymphoid organs
thymusbone marrow
What type of immunity with skin,mucous,BF
natural
what kind of immunity with vaccines
specific immunityartificial active
adaptive immunity w/ab is called
humoral immunity
immunity inside infected cells
cell mediated
Plasma protein that activates complement system of innate
properdin
enzyme that catalyzes destruction of cell walls of bacteria
lysozyme
signal protein release by cells due to virus
interferon
Subtance that stimulates cell locomotion/migration
chemotactic factor
Cell that kills tumor cells nonspecifically
NK
Have receptors that are specific for a tumor/microbe
cytotoxic cells
Combines to larger carriers to elicit immune response but doesn’t elicit on its own
hapten
Enhances immune response
adjuvant
molecule that can elicit an immune response
immunogen
3 secondary lymphoid organs
spleen,tonsils,lymph nodes
Which 2nd lymph organs respond to antigens by making lymphocytes and plasma cells
lymph nodes contain WBCSspleen makes WBCs,ab
cell that specifically kills tumor cells/virally infectedneeds exposure
T cytotoxic
cell nonspecifically kills tumorinnate/no need exposure
NK
Phagocytosis is main function of what cell
PMNs
Genes that control expresson of HLA antigens are called
MHCmajor histocompatibility complex
3 Class I gene products
HLAA,B,C
5 Class II gene productspresent antigen outside of the cell of T lymphs
HLAD-M,O,P,Q,R
Ab increases during convalescence phase(symptoms disappear, return to normal)
IgG
Ig…best precipitinsoluble ag/specific ab
IgG
Ig..best agglutinin
IgM
has 4 subclasses
IgG
Ig…dimer
IgA
2 Ig…monomer
IgG, E
Ig…pentamer
IgM
2 Ig have Jchain
IgM, A
complement are heat…
labile
complement acts as an…and end result of complement is…
opsonincell lysis
Which ab bind complement
IgG/M
First component to bind to immunoglobulin in recognition phase of complementcan bind bacteria,ab,CRP
C1q
Proteases of complement that don’t bind/aren’t active
Clr/s
Complement component that is chemotactic and anaphylatoxicMediator of inflammation andis released to recruit phagocytes
C5a
Factor B,D and properdin is in what pathway
alternate
IgG ab binds to rbc and is reversible is called
sensitization
clumping ag w/ab after sensitization is called
agglutination (IgM best)
Antigen in agglutination inhibition is…which is bound to
Pt serumab reagent
Positive test for aggulutination inhibition
no aggglutionationPT has antigen(in serum) and reagent ab is bound to serum/antigen so it can’t react with indicator
Negative test for agglutination inhibition
agglutinationPT doesn’t have antigen in serum, and reagent ab isn’t bound thus reacting w/indicator
Two examples of agglutionation inhibition tests
hemaggutination inhibition (rubella)latex agglutination inhibition (viruses)
complement fixation positive test is
no hemolysisno C available, complement is fixed, not available to combine w/indicator (SRBC coated w/antiSRBC)
complement fixation
when complement finds/attaches to antibody-antigen complex
complement fixation negative test
hemolysis:no antibody in serum and complement not bound, attaches to indicator/SRBC+antiSRBC and lyse
What type of rxn/test is ab-ag combined in presence of complement to see if hemolysis occursdetects IgM ab w/sheep RBC/antiSRBC/hemolysin
complement fixation (CF)
…quantitatively determines the level of an antigen. Antibody is incorporated into liquefied agar and allowed to gel. The antigen is added to small wells and radiates throughout the antibody-containing medium, leaving a precipitate throughout the gel. The amount of diffusion is quantified.
radial immunodiffusion (RID)ORsingle immunodiffusion
single immunodiffusion also called
radial immunodiffusion (RID)
Rxn where diffusion occurs and a ring of precipitate forms on an agar plate with ab where serum/standards are added
Radial immunodiffusion(RID)Single immunodiffusion
Fahey(kinetic) and Mancini(end pt) are what kind of tests
RID/immunodiffusion/precipitaition
… … is an agar gel immunodiffusion.It is a special precipitation reaction on gels where antibodies react with specific antigens forming large antigen-antibody complexes which can be observed as a line of the precipitate.In…both the antibody and antigen are allowed to diffuse into the gel.After application of the reactants in their respective compartments, the antigen and the antibody diffuse toward each other in the common gel and a precipitate is formed at the place of equivalence.
Double Immuno-diffusion
Another name for double diffusion
Ouchterlony
Test used to determine relationship between ag-ab Ab is added around ab well and diffussion occurs with precipitation bandsConcentration and rate of diffusion dictates location of bandsUsed to id ab w/autoimmune disorders
double diffusion/ouchterlony
Double diffusion pattern that fuse together is
identity
double diffusion pattern that intersect are
nonidentity
double diffusion patterns that parially intersect are
partial identity
Test where ab-ag diffuse thru agar after serum proteins are electrophoresed on agar
immuno-electrophoresis (IEP)
Serum IEP can detect
monoclonal gammopathies
urine IEP can dectect
Bence Jones protein or free light chains
In this method the sample goes through a complex process called electrophoresis. This process singles out the different proteins in your blood. A dye is used to bind to the proteins and stain them.This method “fixes” certain proteins into place with antibodies and then washes away the others before staining them. On a computer screen, these proteins form a pattern of bands. Peaks and valleys in the bands may mean that you may be making too many or too few of certain proteins. The band pattern is specific for certain diseases.
Immunofixation
protein electrophoresis plus immuno-precipitation is called
immunofixation
Immunofixation is used to classify
monoclonal gammoopathies/determine heavy and light chains
name of test where ab-ag migrate toward each other and forms precipitate
countercurrent immunoelectrophoresisCIE
Two examples of RIA, radioimmunoassay
RIST, RAST
Which RIA measures total IgE
RISTradio-immunosorbent test
which RIA measures IgE to specific allergens
RASTradio-allergosorbent test
Which test is a sanwhich tecnique with ab on solidPT serum addedenzyme labeled abenzyme substrate
EIA/ELISA enzyme immunoassay
HIV/Serum HcG/hepatitis mreausred by
EIA/ELISA
EMIT measuresenzyme multiplied immunoassay
small molecules like drugs, hormonesThe enzyme multiplied immunoassay technique (EMIT) is one of the more common drug screening platforms.
Positive EMIT is
colorA change in absorbance is measured at 340 nm by a spectrometer In this enzyme immunoassay (EIA), NAD is reduced to NADH when it reacts with the enzyme G6PD.
Negative EMIT is
no color
Test where insoluble complexes reflects scattered light
nephleometry
FTA-ABS STANDS FOR…TETS FOR…TO…
FTA-ABSFluorescent Treponemal Antibody ABS: absorptionpresence of antibodies to Treponema pallidum
Type of immunohistochemistry technique that utilizes fluorophores to visualize various cellular antigens such as proteins.
Immunofluorescence (IF)
ANA and FTA-Abs can be tested with
immuno-fluorescencefluorescein labeled ab
Positive FPIA
reduction of polarized light
negative FPIA
increased polarized light
FPIA stands for
Fluorescence polarization immunoassay
Time frame to test for infectious disease
acute and convalescent specimens 2weeks apart
Clinically sig titer for infectious disease is
4-fold or 2 tube rise
Ability of test to detect very small amount of a substancwe
sensitivity
ability of test to give positive result if PT has the disease-less false neg
sensitivity
ability of test to detect substance without interference from cross reacting substances
specificity
ability of test to give neg result if PT does not have disease-less false pos
speficity
Name of principle where if person has ab to virus, the virus on the RBCs added will be neutralized and inhibit agglutination
hemaaglutination inhibitionAg are on rbcs
a substance in the blood of persons with syphilis responsible for positive serological reactions for syphilis an antibody (such as IgE in humans) that mediates hypersensitive allergic reactions of rapid onset
reagin
fusing B lymphs w/a plasma myeloma cell is how you make
monoclonal ab
binding strength of single sitesingle antigenic determinent + individual ab
affinity
total binding strength, multivalent ag-b
avidity
reproducible technique for quantitation of a single protein, and is also applicable in a protein mixture. The quantitation is based on measuring the height of the precipitate peak.
one dimensional single electroimmuno-diffusion
one dimensional single electroimmunodiffusion also called
rocket electrophoresisLAURELIn rocket immunoelectrophoresis, antigen migrates in an electric field in a layer of agarose containing an appropriate antibody.
fluorochrome that gives minimal false reading and is green
fuorescein(isothiocyanate)
fluorochrome gives off red at 580nm
tetra-methyl-rhodamine isothicyanate
…tests are an indirect method in that they detect biomarkers that are released during cellular damage that occurs from the syphilis spirochete. …are screening tests, very rapid and relatively simple, but need to be confirmed with…
Nontreponemalconfirm with treponemal tests
….tests look for antibodies that are a direct result of the infection thus, IgG, IgM and to a lesser degree IgA.
Treponemal
The nontreponemal antigens in syphilis are
cardiolipin and lecithin
The VDRL antigens are
cardiolipin and lecithin
Nontreponemal antibody
reagin
…is a fundamental process utilized to facilitate the aggregation of small particles in a liquid or solution to form larger clusters, known as flocs.
Flocculation
VDRL
venereal disease research laboratory
Ab-ag rxn in VDRL test is what type
flocculationThe VDRL test doesn’t look for the bacteria that cause syphilis. Instead, it checks for the antibodies (reagins) your body makes in response to antigens produced by cells damaged by the bacteria.
Which requires heat inactivation, VDRL or RPR
VDRL
In VDRL, each serum sample must be heat-inactivated for…minutes at …prior to testing. If heat-inactivation occurs more than four (4) hours prior to testing, reheat the serum for an additional …minutes at…
Heat inactivate for 30 min at 56CIf >4hrs, reheat 10min at 56C
antigens for RPR
cardiolipin + charcoalThe rapid plasma reagin (RPR) test uses the same antigen as VDRL, but the antigen is bound to a carbon particle to allow visualization of the reaction without a microscope.
reactive RPR forms
black clumps
two nontreponemal tests/reagin tests
VDRL/RPR
Reiter strain serves as a …. in FTA-ABSFluorescent Treponemal Antibody ABS: absorption
absorbent, removes nonspecific ab
In FTA-ABS, what strain is used with serum after absorbed off
NicholsFTA-ABS test system employs nonviable T. pallidum (Nichols strain) cells as a substrate (antigen).
Name of test1.)Absorb ab, Reiter2.)Add Nichols, serum3.)label, fluorescein
FTAfluorescent treponemal ab absorption
most sensitive tests for syphillis
FTS-ABS and EIisa
MHA-TP
Microhemagglutination-Treponema pallidumdetects antibodies
Less likely to be reactive in primary,secondary syphillis in which test
MHA-TPMicro agglutination
Test name that detects treponemal abremove nonspecific ab w/sorbent, react serum w/Nichols strain of pallidium, add fluorecein label
FTA-ABsfluorescent treponemal ab absorptoin test
Test you add live treponemes to PT serum
TPItreponema pallidium immobilization testp
positive TPI
treponemes immobilized
MHA-TP used to detect
ab to T.pallidium
in MHA TP what is PT serum added to
SRBCs sensitized w/T.pallidum
positive MHA TP
agglutination, ab
TP-PA uses what kind of particles
gellatin
Which microflocculation test is screen for CSF syphillis
VDRL
Whici microflocculation test for syphillis does not require heat
RPR
Virus that causes infectious mononucleosis
EBVepstein barr virus
What does the screen for EBV test for
heterophile ab
What is a positive rxn for EBV using the screening rapid diff slide test
greater agg in kidney absorbed cells
What are the indicator cells for the EBV screen rapid diff slide test
Sheep, RBCs
What is the confirmation test for EBV
Tests for ab such as ELISA, CLIA
In CLIA test to confirm EBV, what stage of infection is it when there is a presesnce of IgG/IgM + anti-VCA in absense of anti-EBNA
current or recent
anti-VCA IgM/IgGanti-EAanti-EBNA all are antibodies to what virus
EBV
Anti-EBNA and IgG anti-VCA w/out IgM anti-VCA indicate what stage of infection of EBV
past
Name 5 streptococal ag
streptolysin, streptokinaseDNase: deoxyribonuclease BNADaseHyaluronidase
Streptozyme test:Kind of rxn, what it tests for, reagent used
hemagglutionationtests for abSRBC
Name of specific neutralizaton test for antibody made in group A strep infection
Anti-DNase B test
What is a positve rxn in the anti-DNase B test
green color
Test name where strep abs prevent the lysing of group O rbcs by neutralizing
Anti-streptolysin O neutralization test
What indicates presence neutralizing ab in the anti-strepolysin O neutralizing test
Dilution of last tube shows no hemolysis
Name of reciprocal of dilution of last tube in anti-streptolysin O neutralization test
Todd units
Two tests for strep A antigens
LFA Molecular testing for DNA
What is used to screen for HIV-1 ab
ELISA
2 ways to Confirmation for HIV
Western blotNucleic acid testing
Name of retrovirus that attackes CD4 cells
HIV-1
Cause of CMV
herpes virus
Testing for CMV
ELISA
HepB serology involved in acute phase
HBsAg, HBeAg
Hep B serology involved in early recovery
anti-HBc IgM
Hep B serology involved in recovery, immunity
anti-HBc totalanti-HBsanti-HBe
Hep A serology recent infection
anti-HAV IgM
Order of Hepatitis B ag/ab
HBsAg, HBeAgantiHBc, antiHBe, antiHBs
Paul Bunnell heterophil ab test uses what type of rbc
sheep
Paul Bunnell heterophil ab used to detect
ab from IM
Forssman ab are absorbed by what kind of kidney antigen
guinea pig
Davidsohn diff test uses what kind of rbc
sheep and horse
Which antigen is the somatic antigen used to determine antigenic grouping of enteric bacteria
O
which antigen is the flagellar antigen
H
Widal test tests for what
Salmonella typhi
An elevated O titer in the Widal test indicates
increase in agglutinins to S.typhi
Weil-Felix test detects ab to
Rickettsia
Proteus,OX19-2, agglutination all have to do with what organism
rickettsia
What kinds of strains are OX19 and OX2 antigens
strains of Proteus vulgaris
Widal(typhoid) and Weil-Felix (Rikettsial) detect
febrile agglutinins
Francisella tularensis will cross react with
Brucella abortusF.t./B.a.
To diagnose aspergillosis, titer must be
1:512
India Ink is replacing what test…
cryptococcal antigen test
What inferes w/crytococcal antigen latex agg test
RF
autoimmune disease where IgM/IgG ab are directed against Fc portion of IgG
RA
What type of hypersensitivity is RA, what is formed
Type 3 immune complexes
what does screening test, RF assay for RA detect
serum IgM
Confirmatory test for RA
anti-CCPcyclic citrullinated peptide
Screen test for autoimmune dieases
ELISA
Two tests for ANA are
ELISAIIFindirect immunofluorescence
Antinuclear antibodies are seen in what conditions
SLESjogrensSclerodermaRAMCTD
In IIF for ANA what cells are fixed to a slide
HEp2 cells
Disease where autoab to myelin sheath of nerves/myelin basic protein
MS
In MS, what kind of bands are in CSF but not in serum
oligoclonal IgG
Disease name in hyperthyroidism
Graves Disease
Disease where autoab are directed against TSH receptors (TSH-R)
Graves, hyperthyroidismLess TSH means thyroid makes more T3/T4
In Graves disease what are TSHs and T3/T4 levels
Low TSHIncreased T3/T4
TPO…High levels indicate both…
TPO: Thyroid peroxidase antibodies (TPOAb)High levels of these antibodies are seen in both Graves and Hashimoto’s
TRAb…Sign of…
TRAb:Thyrotropin receptor antibodies (TRAb). These antibodies can be a sign of Graves’ disease.
TSI…Seen in…
The TSI test measures the level of thyroid-stimulating immunoglobulin (TSI) in your blood. High levels of TSI in the blood can indicate the presence of Graves’ disease
TSHR ab…Seen in…
Autoantibodies (Ab) against the thyroid-stimulating hormone receptor (TSHR) are frequently found in Graves
3 ab elevated in Graves
TSHR-ab/TR-AbTSITPO
Graves disease symptoms
anxiousweight loss goiter
Name of disease with hypothyroidism
Hashimotos thyroiditis
Tg/Tg-Ab…Sign of…
Thyroglobulin antibodies (TgAb)Hashimotos thyroiditis
Autoab made against thyroglobulinThyroglobulin antibodies (TgAb). High levels of these antibodies are a sign of this disease.thyroglobulin helps make T3/T4, decreased equals less T3/T4
Hashimotos thyroiditis
In Hashimotos, what are the TSH levels
increased TSH
In Hashimotos, what ab are present
TPOTg/Tg-Ab
Symptoms of Hashimotos
TiredWeight gainintolerance to cold
A type of cancer that develops in the lymph system and has Reed-Sternberg cells
Hodgkin lymphoma, also called Hodgkin disease
IMBurkitts, Hodgkin’sCarcinomaLymproloferative all associated with
EBV
is an aggressive non-Hodgkin B-cell lymphoma, worse prognosis than Hodgkins
Burkitt lymphoma (BL)
Lab finding in IM
Lymphocytosis>50%20% atypicalHetetophile abAb EBV ag
Name of ab formed against Forssman ag (discovered in guinea pig tissue)
Forssman hetetophile ab
IM hetetophile ab are usually Ig…Can react to which 3 rbcs…Absorbed by…Not absorbed by…
IgMHorse, sheep, ox rbcsAdsorbed by beef rbcNot adsorbed by guinea pig kidney cells
Name of test screens for hetetophile ab using titer of abIncubated with sheep RBCHighest dilution of agglutination
Paul Bunnell test
Paul Bunnell test titer needs to be
> 56
Performed when Paul Bunnell is >56
Davidsohn diff test
True false, Paul Bunnell diff between hetetophile ab
False
Test that diff hetetophile ab, uses sheep RBC
Davidsohn diff test
Sig titer in Davidsohn
> 224
Which cells are used in Davidsohn diff test…
Guinea pig kidney cellsBeef rbc
Which cells removes Forssman and serum sickness ab..Which cells are agglutinated by them…
Removed by Guinea pig kidney cellsAgglutination by beef
Which cells remove serum sickness and IM ab…Which cells agglutinate them
Beef rbcs remove IM abGuinea agglutinate IM ab
Ab adsorbed by only guinea kidney cells not beef rbc
Forssman abThus not able to agg the guinea kidney
Ab adsorbed by both guinea and beef
Serum sickness, thus not able to agg either
Ab adsorbed by only beef not guinea
IM, thus not able to agg beef
Adsorption Fossman, Serum, IM
Adsorbed on…Fossman: guinea pig kidneyIM: beef rbcSerum sickness: both
Agglutination: Fossman, Serum, IM
Agglutination Fossman: beef rbcIM: guinea pigSerum sickness: none
2 EBV antigens in early acute phase
EAR, EAD (restricted,nuclear)(diffuse, nucleus, cytoplasm)
2 EBV late phase antigens
VCA (viral capsid)MA (membrane)
2 latent phase antigens EBV
EBNALMP
PT sero neg, lacks ab to VCA they are
Susceptible to EBV
Has IgM to VCA, EBNA absentHigh IgG VCA is what stage of infection
Primary infection
Ab to EBNA, increased EA ab what stage of EBV
Reactivation
Ab to VCA and EBNA what stage
Past infection
E-rosette test used to enermurate
T lymphs
Disease that is hypersensitive to gliadin/gluten
Celiac disease/sprue
4 ab to test for celieac
tTG IgA,GEMA-IgAAGA-IgG
2 HLA markers in all celiac
HLA-DQ 2, 8
Disease where autoab directed against TSH receptors
Graves
Disease where autoab directed against basement mebrane of kidney and lungs
Goodpastures
Disease where autoab directed against thyroglobulin
Hashimotos
Disease where autoab directed against myeline sheath of nerves or myelin basic protein
MS
Disease where autoab directed against acetylcholine receptors at neuromuscular joints
MGmyasthenia gravis
Disease where IgM autoab directed against Fc portion of IgG
RA
Disease where autoab directed against salivary duct,tear duct
SJogrens syndrome
ANA centromere pattern associated with
CREST
Nucleolar ANA pattern associated with these two diseases
SclerodermaCTD connective tissue
SLE ANA patterns
Peripheral(rim)Homogenous(diffuse)
What is used in diagnosing, determining progression, choosing drugs, monitoring diseases
tumor markers
Tumor markers tested using
ELISA
AFP, Alpha Fetoprotein associated with these 3 cancers/organs
liverovary, testes
CEA, carcinoembryonic ag associated with these three cancer/organs
colonbreastlung
CA 15-3 associated with this cancer/organ
breast
4 Breast tumor markers
CA-15-3BR 27-29CEAEstsrogen/Progesterone receptors
2 ovary tumor markers
CA 125AFP
CA 125 what organ/tumor marker
ovary
CA 19-9 what organ/tumor marker
pancreas
2 testes/testicular markers1 prostate
HCGAFPPSA
Beta-2 microglobulin marker for
MM, CLL
Disease with ineffective phagocytosis, defect in neutrophils thus recurrent bacterial infections
CGDchronic granulomatous
Disease with impaired neutrophil function
Chediak-Higashi syndrome
T cell deficiency disease, no thymus
DiGeorge’s syndrome
DiGeorge has no thymus
…
Decreased TH, TH/TS ratio/Tcell proliferation
HIV
Partial combined immunodef, thrombocytopenia at birth
Wiskott-Aldrich syndrome
Complete or marked def of T and B
SCIDsevere combined immunodef
Name of test where dilute serum is added to latex coated AHG to detect ag against IgG
RF latex slide test
Which test…detects IgM, positive doesn’t agg, is a screen, and synovial fluid can be a source
RF factor latex
Anti-RNP indicates
Mixed connective tissue disease
Ab to proteins in centromere of chromosome indicates…
CREST
anti-dsDNA or anti-histone indicates these two diseases…ANA pattern of…
SLEdrug induced lupusHomogenous/diffuse
anti-ds DNA highly suggestive of…has a ANA pattern of…
SLEPeripheral/rim
Anti-RNA, anti-ENA has what ANA pattern…Associated w/most but not…
speckelednot CREST
2 Scleroderma ANA patterns
Nucleolarspeckled
connective tissue ANA pattern
nucleoloar
RA ANA pattern
speckled
2 SLE pattern
peripheral/rim, homogenous/diffuse
Anti-I ab seen in present infections with what ogranism
Mycoplasma penumoniae
After infection with Myco pneumo, what forms
cold agglutinins
Acute/chronic infection HB ag
HBsAg, HBeAg
Vaccinated HB ab
anti-HBs
early recovery HB…recovery HB…
early: antiHBcIgMrecovered: antiHBc,HBs,HBe
HSV that can cause urogenital infections/genital herpes…which one more common in genital herpes
HSV 1,2HSV 2 is 90% of genital herpes
HSV more related to sex, mom passing on, genital
HSV 2
HSV more related to oral, break in skin
HSV 1
HSV 3 is which virus
varicella zoster virus
How to type HSV with high specificity
ELIAA
Serotype HSV with
DFAdirect fluoresecent ab
Cause of chicken pox, spread thru respiratory, spreads to blood, skin and lays dormant in nerves
Varicella zoster virus
Latent varicella zoster turns into
Herpes Zoster, shingles
Serological test for VZV
ELIAA
CMV is diagnosed serologically by detecting
IgM and IgG ab
IgM ab with 4 fold increased in IgG indicates what stage of CMV
active
IgG, no IgM ab indicates what stage of disease in CMV
inactive
Which virus attacks monos/grans/lymphs/episis spread by STI, tranplant tissue, thru placenta
CMV
Why is indirect immunofluorescence not a great test for CMV
Has false positives
Screening test for immunity to rubella
IgG ab
Serological test for rubella, VZV, HSV, and T.gondii
ELIAAenzyme linked immunosorbent assay
Serological test for T.gondii is called
ELIAAIgG, IgE
Mantoux skin/TB test type of hypersensitivity
Type 4 delayed
Type III rxn due to
immune complexes
Type II due to
antibody, transfusion, AIHA
Type I due to
anaphylactic
Ataxia telangiectasia
Louis bargenetic, nervous, immuneataxia
Brutons aggamaglobulinemia
sex linked immunodef, absense of plasma cells thus lack of ab made
Tcell subset enumeration by flow cytometry can be used in what syndrome
DiGeorgethey have no thymus, tcell def
West nile caused by
arbovirus, bite from mosquito (female culex) that feed on birds
Virus that Can attach immune cells, can make BBB more impermeable
WNV
Serologic method for WNV
IgM ab
Giardia common in
water, water parks, vegetables
Diagnositc forms of Giardia
in fecesinfective is cysttroph
Diagnosis Giardia thru 3 ways
fecal ag test, EIA/direct IFAexamine stool cyst/trophbiopsy troph
Lyme diease caused by vector/organism
ticks, Borrelia
2 step testing Serological testing for Lyme
1.)EIA2.)Western blot
Tick that spreads B.Burgdorferi
Ixodes tick, deer
Which Borrelia is in US and causes lyme disease
B.Burgdorferi
Serological diagnosis of Lyme
ELISA
Crytosporidium parvum infectious stage
sporulated oocyst
How is C.parvum transmitted
oocyst is ingested from fecal contam food etcdiarrhea, AIDs
Testing for C.parvum
PCR, Antigen, NAATStool not so sensitive, acid fast stain
Cryptococus
soil, pidgeon droppingsinhalationnarrow based buddingindia ink, halos formlatex agg test for ag PCAAIDs,lung infections, meningitis
Process tags foreign pathogens to be eliminated by phagocytosis
opsonization
process that cells takes in fluid along with dissolved small molecules
pinocytosis
process where person becomes protected against a disease thru vaccination
immunization
plasma glycoprotein that activates the complement system of the innate immune system
properdin
enzyme that catalyzes the destruction of cell walls of certain bacteria
lysozymes
signaling protein made and released by host cells in response to presence of several viruss
interferon
substances that stimulate cellular locomotion/migration
chemotactic factors
3 types of phagocytes in innate immunity that ingest/destroy damaged cells/bacteria in antigen independent fashion and all are from myeloid
macrophages (tissue monos)Neutrophils/PMNsDendritic cells (DCs): are antigen-presenting cells that capture, process, and present antigens to lymphocytes to initiate and regulate the adaptive immune response.
complement and acute phase reactants are part of the
innate immune system
In adaptive immunity, dendritic cells act as
APCengulf and present to B/T cells
Which 3 classes of hypersensitivity are involved in humoral immunity of adaptive system
IIIIII
Immediate, IgE hypersensitivity
I
Immune complex hypersensitivity
III
ADCC, complement hypersensitivity
II
An antigen that ellicit a response from an organisms adaptive immune system
immunogen
ability of agent to elicit a immune response
immunogenicity
enhances immune response
adjuvant
this is recognized by the immune system
epitope
can combine to larger carrier to elicit immune/doen’t elicit on its own; smaller molecules that are antigenic but can’t be immunogenic unless bound to larger molecule such as a protein
hapten
vaccination is a type of
artifical active immunity
two organs that respond to circulating antigens by filtering/producing lymphs and plasma cells
lymph nodes and spleen
T cells differentiate/are dependent in the…B cells differentiate in the…
T cells…thymusB cells..bone marrow
Main function of Thelper…Two other functions..
-activate Bcells to secrete antibody-help macrophages destroy/ingest-activate cytotoxic Tcells
Ab production turned off by
Suppressor T cells
Small polypeptides given off by Tcells that regulate function of phagocytic cells
lymphokines
T cell that specificially kills tumor/virally infected cells
cytotoxic T cells, CD8
effector lymphs that nonspecifically destroy infected cells/cancer that don’t need previous exposure, part of innate
NK
Two types of T helper cells
TH1TH2
which T helper activates macrophages
TH1
which T helper activates B to make antibodies
TH2
Which T cell marker recognizes MHC 1 which is on most cells
CD8
Which T cell marker recognizes MHC 2 which are APC
CD4
Cells of innate that are antigen presenting
dendritic
Foreign body or molecule that will bind to specific antibody or T cells
antigen
The principal function of the… is to present antigen to T cells to discriminate between self (our cells and tissues) and nonself (the invaders or modified self).
MHC
Another name for epitope
determinant
reactive sites of an antigen
epitope/determinant
antibody whose production did not induce
heterologous antigen
Most potent antigen
protein
The 5 types of immunoglobulins are distinguished by their…And is called … …which determines their antibody class
constant region of heavy chainantigenic variation
Term when soluble antigen and soluble antibody form insoluble
precipitin
Best precipitin immunoglobulin
IgG
Term where one antibody binds many antigens
agglutinin
Best agglutinin immunoglobulin
IgM
When symptoms start to disappear and return to normal its called
covalescence
Immunoglobulin in convalescence phase
IgG
IgG has how many subclasses
4
Ig M and A have how many subclasses
2
Two immunoglobulins with J chains
IgM,IgA
Immunglobulin thought to function as antigentic receptor site on B cell surface
IgMIgM is the first class of immunoglobulin made by B cells as they mature, and it is the form most commonly present as the antigen receptor on the B-cell surface.
Immunoglobulins in order of decreasing concentration
G>A>M>D>E
Immunoglobulin has …light chains and …heavy chains
2,2
Which part of immunoglobulin binds to antigen
variable region
Which part has the disulfide bridge
constant region
proteolytic enzyme that fragments IgG into 3 fragments
papain
Fragment termed the antigen binding fragment after cleaved by papain
Fab
F(ab)2 is cleaved by
pepsin
Fc is which fragment of the ab molecule
crystallizable
Hinge region is between
CH1 and CH2
3 functions of complement
inflammationmediates ag/ab reactionsdefends against bacteria viruses
small peptide that is formed during complement activation causing increased vascular permeability, contraction of smooth muscle, release of histamine from mast cells
anaphylatoxin
Plasma proteins normally in circulation that are heat labile and designated by letters and numbers
complement
Complement component in highest concentration in serum in both classical and alternative pathways
C3
All 3 pathways generate protease C3 convertase which binds to pathogen and generates……is the middle man, binds to C3 convertase to form C5 convertase; activates MAC
C3b
Ultimate goal of MAC/complement activation
cell lysis
3 things that affect ag-ab binding1 that doens’t affect
ph, temp, incubation timeenzyme concentration not part of it
Pathway that binds to pathogen surface, C3/B/D/properdin, MAC and cell lysis
alternate
Pathway that binds mannose on pathogen, immune complexes, opsonizes
MB-Lectin
Pathway that is ag-ab, starts with C1q then goes to 4,2,3; involves C5a; inflammation, chemotaxis, anaphlatoxin
classical
Place where optimal precipitation occures, forms lattice;most ab is precipitated by the least of amt of ag
zone of equivalence
Precipitation can be converted to agglutination by increasing the size of the antigen (may be by adding beads etc and getting it to visibly agglutinate)
indirect agglutinationas opposed to direct where the antigen can agglutinate without adding anything
Movement of ag or ab to make ag-ab complexes in semi solid media
immuno-diffusiondiffusion=movement
Ag and ab BOTH free to move toward each other to form a precipitate
2 D diffusion
Ab added to center well, PT sera/stds in weels around center and diffusion results in bands of precipitation.Identity of ab associated with autoimmune disorders
double diffusion/ouchterlony
Gull wing formation occurs when an abnormal protein is electrophoretically displaced from the normal position in what method
CIEcountercurrent immunoelectrophoresis
Heavy and light chains in gammopathies and Bence Jones protein in urine in this method
immuno-electrophoresis
Immunoassay type requires step to separate bound from free label/wash
heterogenous
Immunoassay that doesn’t require a wash step
homogenous
Electrophoresis+immunoprecipitation:After electrophoresis, this method applies antiserum directly to a plate w/strips of agar; antisera added, ag-ab precipitate, wash, stainused for monoclonal gammopathies
immuno-fixation
EMIT is used for urine drugs of abuse where free drug binds to antibody blocking active site; enzyme activity=amt free drug; type of immunoassay is
homogenous
Type of assay where it’s noncompetitive, heterogenous;solid phase wells/ELISA plates/beads;activity/absorbance of detection molecule directly proportional to amount of antigen
sandwich immunoassay
Energy source for fluorescence microscopes
mercury vapor lamp
Fluorochrome used to stain tissue/culture and id microbes with exceedingly bright fluorescence
biotin-avidin
In ELISA, what is attached to the solid phase…ab/ag of unknown sample is added, ab specific for ag w/label is added and then washed
ab or ag
In ELISA AHG is conjugated with…
horseradish peroxidase
Two systems in complement fixation
Test: antibody in serumIndicator: SRBC/antiSheep hemolysin
Indicator in complement fixation
SRBC which are sensitized by anti sheep hemolysin
When checking for anticomplementary factors when using controls for complement fixation there will be…
hemolysis=neg test
Positive control in complement fixation will show..
no hemolysis
Sydrome with tear/salivary glands affected, lymphocytic infiltration; can get bcell lymphoma
Sjogrens
autoantibodies SSA,SSB seen in
sjogrens synydrome(SS)
Condition that can turn into B cell lymphoma
Sjogrens syndrome
Progressive systemic sclerosis also called
scleroderma
SCL-70 antibodies seen in
SCLeroderma
mulitisystem disease, rashes, renal; malar rash (butterfly)
SLEsystemic lupus erthyematosis
SLE has ….and a ….ana pattern.
dsDNA, homogenous
CREST symtoms seen in
limited sclerosis
centromere ANA seen in
limited CREST
ab to RNP only seen in
mixed connective tissue
In Rhematoid arthritis, the antibody is Ig… against the Fc portion of Ig…
IgM against Fc of IgG
anti-CCP
cyclic citrullinated peptide
anti CCP seen in
RA
Screen for ANA..follow up…
ELISAIFA (indirect immunofluorescence)
In IFA, what cells are used in the interphase
Hep2 cells
ANA pattern with even staining of dsDNA…indicative of…
homogenous, SLE/lupus
ANA pattern with nucleoli staining, RNA
Nucleolar
ANA pattern with SSA, SSB
speckled
ANA pattern with dots, CREST
centromere
Thyroid disease with autoantibodies against thyroid
Hashimotos
autoantibody in hashimoto
Tg-ab thyroglobulin
Thyroid disease with stimulating and blocking ab against TSH receptor
Graves
3 Antibodies against TSH-R
TSI, TRab, TSH-R ab
Distinguish Brutons agammaglobuneia versus transient hypoagammaglobunemia
absense of mature CD19B cells
Xlinked, males immunodef dealing with CD19 B cells
brutons agammaglobulinemia
Leukemia versus lymphoma
leukemia blood, lymphoma tissue
Two conditions from sequalea of S.pyogens infection
rheutmatic feveracute glomerlonephretitis
syphillis Stage with lesion/chancre
primary
syphillis stage thats contagious
secondary
syphillis stage thats noninfectious
latent
syphillis stage with scarring, CNS invovlement
late
Nontreponemal tests for…Treponemal tests for…
cardilipinsproteins of T.pallidum
In EBV, presence of antiVCA and EA indicate
recent infection
In EBV, presence of only EBNA indicates
past infection
Two parasites water borne, diarhea
cryptosporidium, Giardia
Syphillis nontreponemal antigen and antibody produced to it
cardiolipin=agreagin=ab
cardiolipin and lecithin used in what test
VDRL
How often are the needles used to deliver VDRL antigen checked and the stability of the VDRL antigen suspension checked…how many drops for antigen needle qualitative VDRL…how many drops for saline needle quantitative VDRL…
dailyantigen qualitative 60drops/mLsaline quantitative 100drops/mL
Nontreponemal:cardiolipin,lethicinheat inactivation (to destroy complement)CSF
VDRL
Nontreponemalcardiolipin,Plastic coated cards
RPR
Initial time/temp to heat inactivate VDRL…Reheat time/temp to heat inactivate VDRL…
initial 30min @56Creheat 10min @56C
VDRL:serum:antigen…small clumps, many free particle interp…titer reactive/weak reactive perform…report quant as…
3:1 more serum-small clumps/many free: weakly reactive-titer reactive/weak perform quantitative-quantitation titer is highest dilution giving reactive result
RPR antigen needle drops…RPR rotated at…for…
60 drops/mL100rpm for 8 mins
Falso pos not caused by syphilis seen in
nontreponemal testing
antistreptolysin O (ASO) measures
ab to streptolysin O
antistreptolysin O slide test uses/postive is..antistreoptolysin O tube test uses/pos is…
slide: agglutinationtube: no hemolysis
in antistreptolysin O tube test, a positive test is…measured in…
positive is no hemolysislast tube with no hemolysis in Todd units=neutralizing ab present
classic antistreptolysin O test the reagent is destroyed by…
destroyed by oxygen
Streptoccocal extracellular product that dissolves fibrin clots
streptokinase
Heterophil ab test screens for…Reported as…
EBV,IMhighest dilution w/agglutination
Paul Bunnell heterophil ab test uses
SRBCsthat agglutinate with heterohile ab from IM
Heterogenic antigen on tissue/organs(kidney) of guinea pig
Forssman antigen
What are absorbed by guinea pig kidney antigen
Forssman antibodies
