immunodigntostic

Question 1

• immunodiagntostics include:
  *Transplant eg – typing
• – mediated hypersensitivity
• — pathways
• laboratory tests are useful if they help:
  *To rule – a diagnosis
  *To rule – a diagnosis
  *To – disease activity
  -False positive and false negative results are common
  -There is not a test for everything – clinical diagnostic
  skills essential

Answer 1

HLA
IgE
complement
in
out
monitor

Question 2

factors affecting the test:
* Preanalytical
➢Intelligent – selection
➢Patient –
➢Correct – / Correct –
➢Order of Draw of –
* Analytic
➢Assay –
➢Quality – within the lab
* Post analytic
➢ – the test
➢Ensuring result is — and – upon
( if in doubt , ask )

Answer 2

test
preparation
tube and identification
samples
performance
factors
interpreting
seen n acted upon

Question 3

order of draw:
-Vacuum blood collection systems
-Must fill and handle
tubes as directed
-Prevent contamination with –
from subsequent tubes

Answer 3

anti cogulatants

Question 4

frequently ordered lab tests - clues:

Answer 4

*FBC/CBC - Full/Complete Blood Count
*Renal, Liver, Bone Profile
*Coags (Coagulation studies)
*Urinalysis
*Inflammatory markers WCC, CRP, ESR
*Acute Phase Response ( as ferritin fribrongen serum etc)
*Organ/System dysfunction
*Monitor complications of treatment
check slides for pics

Question 5

in inflammatory markers:
1- CPR aka c reactive proteins are generally preferred:
* – half life
* Levels increase within – of the triggering stimulus.
* Fall again within a few – of response.
2- ESR is elevated with – , inc – & —rich states, making interpretation difficult.
* Significant – phases between onset and resolution of inflammatory
stimuli. Good indicator of —

Answer 5

short
6-8 hr
few hours
anemia increased age n oestrogen rich
lag phase
chronic inflammation

Question 6

• – is the study of immunological proteins within different biological fluids including serum, urine and
  CSF.
• The detection of these proteins employs a range of differing techniques
• Many take advantage of the – bond, this interaction is highly specific!

Answer 6

immunochemistry
antigen antibody bond

Question 7

—- pairs tag for detection
-Assays Based on the Formation of individual– pairs, in which detection relies on a “ – ” – introduced onto either the – or the – molecule.
➢ ELISA
➢ Indirect Immunofluroescence
➢ Flow Cytometry eg lymphocyte subsets

Answer 7

antigen - antibody pair
antigen-antibody pairs
tag
chemically
antigen or antibody

Question 8

detection of autoantibodies includes :

Answer 8

*Agglutination
*Nephelometry – large analyser
*Indirect Immunofluorescence
*ELISA ( enzyme linked immunosorbent assay)

Question 9

• aggluation assays:
• – coated beads or
  cells + patient serum
  *No antibody – remain in –
  *Antibody present – – and –
  together

Answer 9

antigen
suspension
angluniate n clump
( check slide 19,20,21,23)

Question 10

diagnosis of RA:
➢ – , – and – diagnosis
1- – classification Criteria
➢ An approach to classifying RA
➢ Discriminate between those who are/are not at high risk for persistent or erosive disease
2- Immunology tests included:
➢ –
➢ –

Answer 10

clinical. radiological and serological
ACR
rheumatoid factor
anti ccp
( check slide 25)

Question 11

immunodiagnostic in RA:
1- — : – moderate sensitivity, poor specificity detected in other CTDs, infection, inflammation and healthy population.
2- — – excellent specificity excellent sensitivity for joint disease
➢ Neither antibody sufficient to establish a Diagnosis
➢ Both are included in classification criteria, but both not required.
➢ Clinical Diagnosis - classification criteria considered.
3- – – disease activity

Answer 11

RF
anti CCP
CRP
( check slide 27,28,31)

Question 12

treatment:
Severe disease with early joint destruction evident
* – help with pain, but do not – disease
* – often used initially
* Disease very aggressive
* Highly – – patient keen to get pregnant
*Commenced on – (anti-TNFalpha mab; IV)
*Given at 0, 2 & 6 weeks
*Excellent response – given – for maintenance

Answer 12

NSAIDS
control
methotrexate
highly tetrpgenic
infliximab
8 weekly

Question 13

immunodeficiency:
*Pattern of –
*Additional Features e.g. – ,—,–
* – , – - – or –
*Components- – & –
* – or –

Answer 13

infection
dysmorphic, autoimmunity,
Family History
innate or adaptive
cellular or humeral
number n function
primary or 2ndary

Question 14

clinical assessment of t cel function:
* Clinical History – – / – problems
* –
* – counts
* – numbers & subtypes
* Expression of – , – receptors etc
* Genetic testing for T cell/combined immunodeficiencies
* (Delayed – skin tests)
* ( – with protein antigens)
* – assays

Answer 14

infection and vaccines
HIV
lymphocyte
T cell
TCR and cytokine receptor
hypersensitivity
vacciantion
proliferation

Question 15

assessment of humoral immunity :
* – history
*Measurement of –
–> – subclasses
–> – activity
* — (SPEP)
*Functional assessment of – production
* – induced antibodies
*Test –
*– Numbers (Tonsils/Blood/BM)
* – testing for known humoral
immunodeficiencies

Answer 15

clinical
immunoglobin
IgG
complement
serum protein electrophoresis
antibody
vaccines
vaccines
b cell
genetic

Question 16

serological testing for infectious disease:
*Measure – to potential infecting agent
*Very useful for organisms which are – to grow
*Most – and some other –
*Usually measure – and – antibodies to the potential infecting organism

Answer 16

antibodies
hard
viruses n pathogens
IgG , IgM

(check slide 39)

Question 17

summary:
* – skills essential in making a diagnosis
* – and – guide test selection and interpretation
* – of test performance is essential in interpretation to make a diagnosis.
* — are widely used in diagnostics
* No test is perfect – all have false positives and false
negatives
* You need to consider – which affect results and interpretation

Answer 17

clinical
history n examination
knowledge
monoclonal antibodies
factors