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Externship Chemistry/Immunology > Immunology CH 3.4 Autoimmune Disease > Flashcards

Immunology CH 3.4 Autoimmune Disease Flashcards

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1
Q

what is the general definition for autoimmunity?

increase of tolerance to self antigens
loss of tolerance to self antigens
increase in clonal deletion of mutant cells
manifestation of immunosuppression

A

loss of tolerance to self antigens

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2
Q

An ANA test is performed on a specimen from a 55yr woman who had unexpected joint pain. IFA result shows a titer of 40 and a homogenous pattern. The appropriate follow up testing is:

anti-DNA assay
extractable nuclear antigen ENA testing
retest ANA in 3-6mos
CH50 compliment assay

A

retest ANA in 3-6mos

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3
Q

what disease is likely to show a rim (peripheral) pattern in immunofluorescence (IF) microscopy test for ANA?

Mixed connective tissue disease (MCTD)
RA
SLE
Scleroderma

A

Active SLE

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4
Q

a pts specimen is strongly positive in an ANA ELISA. Which of the following would not be an appropriate follow up to this result?

IFA on human epithelia type 2 HEp2 cells
specific ELISA ENA tests
specific anti-DNA ELISA
Rheumatoid factor assay

A

Rheumatoid factor assay

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5
Q

what type of antibodies is represented by the homogenous pattern in the IFA for ANAs?

antihistone antibodies
anticentromere antibodies
anti-ENA anti-Sm and anti RNP antibodies
anti RNA antibodies

A

antihistone antibodies

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6
Q

what disease is indicated by a high titer of anti-sm antibody?

MCTD
RA
SLE
Scleroderma

A

SLE, causes a speckled pattern

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7
Q

which disease is least likely when a nucleolar pattern occurs in an IFA for ANAs?

MCTD
Sjorgens syndrome
SLE
Scleroderma

A

MCTD

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8
Q

what antibodies are represented by the nuceolar pattern in the IFA for ANAs?

antihistone ab
anti-dsDNA ab
anti-ENA ab
anti-RNA ab

A

anti RNA ab

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9
Q

which test would be best to distinguish between SLE and MCTD?

muliplex/ELISA test for anti-sm and anti-RNP
IFA using crithidia as a substrate
slide agglut test
lab tests cannot distinguish these

A

Multiplex and ELISA or anti-sm and Anti-RNP

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10
Q

An ANA test on HEp-2 cells shows nuceloar staining in the interface cells and dense chromatin staining in the mitotic cells. the most likely cause of the staining is

antifibrinillarin antibody
anti-ribosomal P antibody
a serum with nucleolar and homogenous patterns
technical artifact

A

antifibrinillarin antibody

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11
Q

Which immunoflourescne pattern indicates the need for ENA testing by multiplex, line blots or ELISA assay?

homogenous or solid
peripheral or rim
speckled
nucleolar

A

speckled

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12
Q

which of the following is used in rapid slide tests for detection of RFs?

whole IgM molecules
Fc portion of the IgG molecule
Fab portion of the IgG molecule
Fc portion of the IgM molecule

A

Fc portion of the IgG molecule

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13
Q

which if the following methods is least likely to give a difinitive result for the diagnosis of RA?

nephlometric measurement of anti-IgG
agglut testing for RF
anti-CCP
IFA or ANAs

A

IFA or ANAs

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14
Q

which disease might be indicated by antibodies to smooth muscle?

atropic gastritis
autoimmune hepatitis
myasthenia gravis
sjorgens syndrome

A

autoimmune hepatitis

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15
Q

antibodies to thyroid peroxidase may appear in which of the following diseases?

graves disease and hashimotots thyroditis
myasthenia gravis
granulomatous thyroid disease
addisons disease

A

graves disease and hashimotos thryoiditis

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16
Q

what is the main use of laboratory test to detect antibodies to islet cells and insulin in cases of insulin-dependent diabetes mellitus (IDDM)

to regulate levels of injected insulin
to diagnose IDDM
to rule out the presence of other autoimmune diseases
to screen susceptible individuals prior to destruction of b cells

A

to screen susceptible individuals to prior destruction of b cells

17
Q

a pt presents with symtoms of celiac. tests for anti-tissue transglutaminase and antigliadin antibodies are negative. which of the following tests should be ordered

IgG level
HLA DQ2 and DQ8 typing
HLA DQ3 and DR7 typing
IgM level

A

HLA DQ2 and DQ8 typing

18
Q

a specimen appears to have perinuclear staining pattern in an antineutrophil cytoplasmic antibody (ANCA) assay using ethanol fixed neutrophils, suggesting the possibility of perinuclear ANCA. on which of the following substrates would this specimen display cytoplasmic speckling?

formalin fixed neutrophils
unfixed neutrophils
HEp-2 cells
rabbit kidney tissue

A

formalin fixed neutrophils

Externship Chemistry/Immunology (9 decks)

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