Immunology

Question 1

soluble antigen + antibody
crosslinking causes positive

Answer 1

precipitation assay

Question 2

insoluble antigen + antibody
clumping causes positive

Answer 2

agglutination assay

Question 3

2 types of agglutination assay

Answer 3

• direct: antigen is insoluble
• indirect: soluble antigen is attached to a particle, like a latex bead

Question 4

explain double diffusion method

Answer 4

AKA immunodiffusion
antigen and antibody migrate toward one another in gel

lines meet perfectly: identity, +
one line is longer: partial identity, =
lines cross: nonidentity, =

Question 5

prozone

Answer 5

antibody excess
false =

Question 6

postzone

Answer 6

antigen excess
false =

Question 7

positive vs negative on complement fixation assay

Answer 7

positive: no hemolysis; C’ is bound to patient’s Ag-Ab complexes
negative: hemolysis; C’ is not bound

Question 8

IgM anti-IgG

Answer 8

rheumatoid factor

Question 9

disguises an IgG as an IgM

Answer 9

rheumatoid factor

Question 10

high RF titer

Answer 10

SLE
RA

Question 11

low RF titer

Answer 11

syphilis
hepatitis
elderly

Question 12

explain nephelometry

Answer 12

precipitation test read by spectrophotometer

Question 13

4 stages of syphilis

Answer 13

primary: lesion
secondary: rash
latent: no sx
tertiary: systemic involement; neurosyphilis

Question 14

nontreponemal tests
detect what?

Answer 14

RPR & VDRL
screening
detects anti-cardiolipin reagin Ab

Question 15

treponemal tests

Answer 15

IFA, TPA
confirmatory
organism is the Ag

Question 16

flocculation test

Answer 16

RPR

Question 17

anti-cardiolipin

Answer 17

positive in syphilis patients

Question 18

when are RPR and VDRL positive?

Answer 18

1° and 2°syphilis

Question 19

when are treponemal tests positive?

Answer 19

any stage of syphilis

Question 20

looks for neurosyphilis in the secondary stage
done on CSF

Answer 20

VDRL

Question 21

false + RPR test

Answer 21

malaria
mono
SLE
other autoimmune

Question 22

cells used to test for anti-I/i

Answer 22

adult and cord O cells, washed and kept warm

Question 23

neutralization test that may help dx Strep group A or sequelae

Answer 23

ASO
(streptolysin O)

Question 24

Coomassie stain

Answer 24

CSF protein electrophoresis

Question 25

prealbumin band

Answer 25

shows up in CSF

Question 26

CSF index & normal

Answer 26

index = (CSF IgG/CSF alb)/(serum IgG/serum alb)

normal —<0.66

Question 27

elevated CSF index

Answer 27

MS
syphilis, other diseases causing CNS IgG production

Question 28

uses specific anti-sera to ID monoclonal & BJ proteins

Answer 28

immunofixation

Question 29

Hep2

Answer 29

ANA substrate

Question 30

ANA homogeneous pattern

Answer 30

SLE
reflex to nDNA

Question 31

nDNA +
organism

Answer 31

Crithidia lucillae
kinetoplast fluorescence
SLE

Question 32

anti-ssDNA +

Answer 32

drug-induced lupus

Question 33

ANA rim pattern

Answer 33

SLE

Question 34

ANA speckled pattern

Answer 34

reflex to ENA

Question 35

ENA Smith +

Answer 35

SLE

Question 36

ENA RNP +

Answer 36

SLE, MCTD

Question 37

ENA SSA/SSB +

Answer 37

Sjogren’s syndrome

Question 38

ANA centromere pattern

Answer 38

CREST syndrome

Question 39

ANA nucleolar pattern

Answer 39

PSS or SLE

Question 40

MSK
renal tubules & parietal cells

Answer 40

AMA
primary biliary cirrhosis

Question 41

MSK
stomach muscle & blood vessel walls

Answer 41

ASMA
chronic active hepatitis

Question 42

MSK
Parietal cells

Answer 42

APCA
pernicious anemia

Question 43

C-ANCA and P-ANCA

Answer 43

Wegener’s granulomatosis
systemic vasculitis

Question 44

ACh receptor antibody

Answer 44

myasthenia gravis

Question 45

thyroglobulin Ab

Answer 45

Hashimoto’s

Question 46

purpose of direct IFA

Answer 46

look for immune complexes in patient tissue

Question 47

HBV decreased infectious state

Answer 47

HBeAb +

Question 48

RIBA method

Answer 48

HCV IgG

Question 49

used most frequently to screen for HIV

Answer 49

HIV1/2Ab + p24 Ag test

Question 50

2/3 antigens that need to be + on Western blot for HIV confirmation

Answer 50

p24
gp41
gp120/160

Question 51

earliest HIV marker

Answer 51

HIV p24 test

Question 52

used to monitor HIV patients

Answer 52

• HIV RNA - viral load
• HIV genotyping - mutations
• CD4/CD8 ratio

Question 52

CD4 count indicating AIDS

Answer 52

<400

Question 53

HAART

Answer 53

highly active antiretroviral therapy
for HIV

Question 54

low MW particle requiring a carrier for immunogenicity

Answer 54

hapten

Question 55

most reliable test for Lyme

Answer 55

Western blot

Question 56

first Ab on surface of new B-cells

Answer 56

IgD

Question 57

CD38

Answer 57

plasma cell marker

Question 58

causes class switching

Answer 58

CD40 (B) + CD40 ligand (T)

Question 59

need presentation on MHC II

Answer 59

CD4

Question 60

need presentation on MHC I

Answer 60

CD8

Question 61

deficiency of C1 esterase inhibitor

Answer 61

hereditary angioedema (HANE)

Question 62

measures complement activity, not concentration

Answer 62

CH50 test

Question 63

C’ proteins are ——– labile

Answer 63

heat
freeze serum immediately for C’ testing

Question 64

IgE hypersensitivity
allergies
histamine

Answer 64

type I

Question 65

complement hypersensitivity
transfusion rxn

Answer 65

type II

Question 66

ag-ab complex hypersensitivity
Arthus rxn

Answer 66

Type III

Question 67

delayed hypersensitivity
T-cell mediated

Answer 67

type IV

Question 68

IgG deficiency
no mature B-cells

Answer 68

Bruton’s agammaglobulinemia

Question 69

no/few T-cells due to failure of thymus to develop

Answer 69

DiGeorge syndrome

Question 70

low IgM
males
thrombocytopenia, small plts

Answer 70

Wiskott-Aldrich syndrome

Question 71

low level of lysosomal enzymes
partial albinism
giant cytoplasmic inclusions

Answer 71

Chediak-Higashi

Question 72

G6PD deficiency
MPO and ALP ↓ in neutrophils

Answer 72

chronic granulomatous disease