Immunodiagnostics 1 Flashcards
Simple Immunodiagnostic Tests
Full blood count and protein electrophoresis
Specialised Immunodiagnostic tests
Immunoassays, immunofluorescence and immunophenotyping
Immunodiagnostics Function
Diagnosis, treatment monitoring and monitoring patient response (need to increase/decrease immune response)
Infection def
Inability to clear infection (active symptoms). Indicated by elevated immune cells (particularly neutrophils)
Primary Immunodeficiency Def
Genetically lacking a component of our immune system
Secondary Immunodeficiency Def
Losing a component of our immune system due to factors in our environment. Eg immunosuppressant drugs
Malignancy Def
Over proliferation of a cell. Mainly effects: t cells, B cells, macrophages, dendritic cells and mast cells
Autoimmunity Def
Immune attack against our own bodies. Increased antibody production against self peptides
Allergy/hypersensitivity Def
overreaction of our immune system to a non-infectious agent. Increased antibodies agaisnt allergen
Disorders of the immune system
infection, hypersensitivity, autoimmunity, immunodeficiency and malignancy
Examples of samples collected
Blood, urine, cerebral spinal fluid, bone marrow aspiration and biopsy
Full Blood Count Outline
1st line of immune disorder screening. Gives information of blood’s components. Specimen = whole blood collected by venipuncture. Blood is added to tube with EDTA potassium salts (anticoagulative - allowing clear sample). 2 methods: automated/manual blood count
How blood settles in tube
Plasma (top), buffy coat and erythrocytes (bottom)
Plasma contents
Blood proteins: albumins, globular proteins (antibodies), fibrinogen and regulatory proteins
Buffy Coat Contents
Immune cells: platelets, leukocytes, monocytes, neutrophils, eosinophils and basophils
Automated Blood Count Outline
Haemology instrument uses multiple parameters and methods to count cells. Quantitative and morphological examination
Manual Blood Count Outline
Visual examination of blood smear under microscope by trained personel. Quantative and morphological examination
Low white blood cell count (low buffy coat cells) outline
Leukopenia. Caused by bone marrow disorder, autoimmune conditions, sepsis (immune system exhaustion), lymphoma (bone marrow cancer), dietary restriction or immune system disorders
High white blood cell count (high buffy coat density) Outline
Leukocytosis. Caused by infection (bacterial/viral), inflammation, leukemia, myeloproliferative disorders, allergies and tissue death
Neutrophil Count elevated and lowered causes
Elevated: acute infection, autoimmunity. Lowered: sepsis
Lymphocyte ( B and T cells) Count elevates and lowered immune cells
Elevated: chronic infection, malignancy. Lowered: sepsis, HIV
Monocytes count elevated/lowered causes
elevated: chronic inflammation. lowered: N/A
Eosinophils elevated/lowered count causes
elevated: parasitic infection. lowered: N/A
Basophils elevated/lower count causes
Elevated: allergy. Lowered: N/A
Differential blood smear function
Visually observe morphology of cells (evaluate malignancy) and see how count is skewed
Acute Lymphoblastic Leukemia
Accumulation of high levels of progenitor lymphoid (t and B cell precursor) cells. Crowd out other cells resulting in reduced erthrocytes, mature leukocytes and platelets
Acute myeloid leukemia
Accumulation of myeloid progenitor (neutrophil/eosinophil/basophil). reduces erythrocytes, leukocytes and palettes
Chronic myeloid leukemia
Accumulation of mature myeloid cells (basophils, eosinophils, nutrophils)
Serum Protein Electrophoresis Outline
Diagnoses abnormal protein production. Ordered for protein in urinary, malignancy test, autoimmune disease and acute/chronic infection. Preformed on blood serum or CSF acquired by venipuncture and stored in serum separating tubes
Other names for antibodies
gamma globulin = immunoglobulin
Electrophoresis Method
Electricity passing through cell separates proteins out based on size, heaviest moves least (albumin) and lightest moves most (gamma globulin). Able to observe density of proteins based on colour (more dense = darker).
Normal densities
Albumin is most dense, gamma globulin = most dense globulin (second most dense on sheet)
Monoclonal/ M-protein Gammopathy
Indicator of malignancy. Identified by narrow dense band (same height as albumin) of immunoglobin (1 particular antibody being produced in excess)
Polyclonal Gammopathy Outline
Indicator of infection. Identified by broader denser then average peak (multiple antibodies being expressed by multiple plasma cells)
No peak outline
Indicates immunodeficiency. Plasma cells aren’t producing antibodies
2 types of antibody light chain
Kappa and Lambda
Immunofixation Electrophoresis Outline
Used to evaluate exact antibodies in infection
Immunofixation Electrophoresis Method Outline
Add patient serum to 6 wells (1 for each antibody), antigen-antibody complex precipitates in gel and entire gel is stained. Identifies immunoglobulin present in monoclonal bands. Determines presence of heaviny chain (IgA,IgG..) and determines presence of light chain
Myeloma Outline
Monoclonal M protein (mainly IgG) . Symptoms: severe anaemia, bone pain, weakness and reoccurring infections
