Immunology CH 3.8 Problem Solving Flashcards
which of the following serial dilutions contains an incorrect factor?
1:4, 1:8, 1:16
1:1, 1:2, 1:4
1:5, 1:15, 1:45
1:2, 1:6, 1:12
D
a pt was tested for syphillis by RPR and was reactive. A TP-PA test was performed and the result was negative. Subsequent testing showed the pt having high titer of ACAs by ELISA. which routine test is most likely abn for this pt?
APTT
anti smooth muscle antibodies
AST
C3 assay by immunonephelometry
APTT
inflammation involves a variety of biochemical and cellular mediators. which of the following may be increased within 72 hr after initial infection.
neutrophils, macros, ab, complement, alpha 1 antitripson
macros, t cells, ab, haptoglobin, fibrinogen
neuts, macros, complement, fibrinogen, CRP
macros, t cells, b cells, ceruloplasmin, complement
C
An 18 mos boy has recurrent sinopulmonary infections and septicemia. Bruton thymidine kinase def is suspected. which test result would be markedly decreased?
serum IgG, A and M
total t cell count
both T and B counts
lymph proliferation w phytohemaggutin stimulation
serum IgG, IgM and IgA
a pt recieved 5 units of FFP and developed anaphyactic rxns. he has a hxt of respiratory and gastrointestinal infections. post transfusion showed all units to be ABO compatible. which test would help determine the cause of transfusion rxn?
complement, C3/C4
flow cytometry for T cell counts
measurement of Igs
NBT test for phagocytic function
measurement of Igs
IFE revealed excessive amoujnts of polyclonal IgM in low conc. of IgG and IgA. what is the most likely explanation of these findings and course of action?
proper amounts of antisera were not added, repeat both tests
test was nit added properly, repeat both procedures
pt has common variable immunodef, preform b cell count
pt has immdef w hyper-M perform CD40 ligand (CD154) analysis
D?
a 54yr male had a seizure. tests were negative including RPR. this dr suspects tertiary syphillis. what test can be done next?
repeat RPR followed by VDRL
treponemal test, TP-PA on serum
VDRL on CSF
no lab test is positive for late syphillis
treponemal test like TP-PA
pt complains of rash, stiff neck, headaches and sleep problems. elevated ESR and slight increased liver enzymes. he returned from a hunting trip in new york 4wks ago. Lyme disease is negative. what is the explanation of these results?
ab response is not sufficient to be detected at this stg
lab and results are not characteristic of lyme
pt has early stg HBV infection
lab error has caused a false neg
ab response not sufficient to be detected at this stg
19yr girl complains of sore throat and fatigue. lymphadenopathy was noted. reactive lymphs noted on diff but rapid test for ab to IM negative. liver enzymes slightly elevated. what should be ordered next?
hepatitis test
EBV serological panel
HIV confirmatory test
Bone marrow biopsy
EBV serological panel
pt recieved two units of RBCS. two wks after surgery, pt was seen by physician and was found to have mild jaundice and slightly elevated liver enzymes. hepatitis testing was negative. What should be done next?
nothign until more severe or difinitive signs appear
repeat hepatitis immediately
repeat hepatitis in a few weeks
check blood bank donor records and contact donors of transfued units
C repeat testing in a few weeks for hepatitis
A hospital employee received hepatitis vaccine 3wk ago. she wants to donate blood. which of the following results are from the hep screen and will she be allowed to donate?
HBsAg pos, HBcAg neg - she can donate
HBsAg neg, HBcAg pos, she may not donate
HBsAg pos, HBcAg pos, she may not donate
HBsAg neg, HBcAg neg - she may donate
D
A preg woman came to dr with maculopapular rash on face and neck. her temp was 37.7 Rubella tests for both IgG and IgM are positive. what pos test wold reveal a diagnosis of congenital rubella synd in her baby after birth?
pos rubella tests for both IgG and M pos rubella test for IgM
pos rubella test for IgG
no pos test is revealed in congenital rbella
B
a pt w RA has acute pneumo but a negative result on throat culture. Dr suspects M.pneumoninae and requests IgM spec ab test. the result is pos with a titer of 1:32. test is repeated 3wk later and titer is 1:32, what test should be performed to determine if the pt truely has M.pneumoniae
IgG anti-m. pneumoniae
cold agglutinins
m.pnneumo PCR or molecular assay
respiratory culture
PCR or molecular assay
pt has PSA of 60ng/mL the day before surgery to remove a tumor. one week post, serum PSA was 8ng/mL by the same method. what is most likely the cause of this result?
incomplete removal of malignancy
cross rxn of ab with another tumor ag
testing too soon after surgery
hook effect w PSA asay
testing too soon after surgery
a pt with sympt associated w SLE and scleroderma was eval by immfluorescn for ANA by using HEp-2 cell line. the cell line had mixed fluorecn that could not be separated by dilutions. which procedure would be most helpful in ID of the ab profile of this pt?
use of diff tissue substrate
absorption of serum using the app tissue extract
request new specimen
ELISA test for specific ab
ELISA for specific Ab
