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604 Immuno/Microbio - Exam 3 > Immunology Lab > Flashcards

Immunology Lab Flashcards

1
Q

Monoclonal Gammopathies are also called

A

plasma cell dyscrasias

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2
Q

What occurs in monoclonal gammopathies?

A

There’s an abnormal proliferation of a clone of Ig secreting cells (usually plasma cells) resulting in the production of monoclonal (M) antibody (protein)
- All antibodies they produce are identical b/c they’re from the same clone

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3
Q

Antibodies in multiple myeloma

A

IgG, IgA, IgE, IgD, or light chains only

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4
Q

Primary amyloidosis is often referred to as

A

Bence Jones proteins

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5
Q

___ is produced in primary amyloidosis

A

excess free light chain

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6
Q

Example of lymphoproliferative disorder in primary amyloidosis. what antibody to they make?

A

waldenstrom’s macroglobulinemia
Only makes IgM

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7
Q

___ is a classic symptom of patients w/ multiple myeloma

A

Bone pain

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8
Q

Over time, monoclonal or polyclonal antibody will be major antibody in patients plasma as disease progresses

A

Monoclonal

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9
Q

___% of patients have mandibular involvement for myeloma patients, and 15% of them have ___ showing up in mandible at first

A

30
primary presentation

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10
Q

Describe serum protein electrophoresis (SPE). what are the steps?

A

performed to detect the presence of an M protein suggesting a diagnosis of multiple myeloma or waldenstrom’s macroglobulin

Patient serum is placed on gel → protein w/ greatest negative charge migrates to positive end of electrode → gel is put in densitometer which draws out what different patients serum looks like

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11
Q

___ migrates in serum protein electrophoresis

A

Albumin

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12
Q

If a patient has ___, the gamma globulin region is down to the baseline b/c patient wouldn’t be making antibodies

A

x-linked ammaglobulinemia

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13
Q

Describe monoclonal response in serum protein electrophoresis

A

a clone of plasma cells expands & makes same antibody & produce M protein

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14
Q

Describe polycloncal response in serum protein electrophoresis

A

different clones of cells contribute to the pattern & make antibodies w/ different specificities so migrate differently
- This is seen in normal patients

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15
Q

When is the earliest detectable time for patients w/ multiple myeloma?

A

Close to patient death, so have to treat aggressively

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16
Q

A polyclonal response is also called ___. Is it cancerous or benign?

A

plasma cell granuloma
Benign

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17
Q

___ is a form of multiple myeloma

A

Plasmacytoma

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18
Q

Immunohistochemical staining steps

A
  • Tissue biopsy + add antibody against kappa (reacts w/ kappa light chain) to 1 section & a 2nd section against lambda (reacts w/ lambda light chain) & both antibodies are labeled w/ an enzyme wash to remove excess antibody + add enzyme substrate
  • Then look for color deposit in tissue when enzyme activates substrate
19
Q

If you have a lesion in the mouth you need to do what to determine if it’s malignant or benign?

A

Need to stain tissue for kappa & lambda light chain expression

20
Q

If plasma cell stains only for kappa or only for lambda
If plasma cell stains both for kappa & lambda

A

multiple myeloma

granuloma (polyclonal response)

21
Q

Amyloid deposits may consists of ___

A

free monoclonal kappa or lambda light chains has deposited in tissue

22
Q

How do stain amyloid deposits to see them under a light microscope? What will you see?

A

stain the tissue w/ congo red & under a light microscope w/ polarized light & you’ll see apple-green birefringence

23
Q

history of blurred vision & bleeding gums is what type of monoclonal gammopathies

A

Primary amyloidosis, specifically waldenstrom’s macroglobulinemia

24
Q

Describe IgM in waldenstrom’s macroglobulinemia. It is associated w/ ___ syndrome

A

IgM is so large that it remains in blood (Increase of IgM in blood) & won’t go into tissue (doesn’t readily get out of vascular system) & has difficulty crossing mucosa b/c IgA competition

hyperviscosity syndrome

25
Q

Hyperviscosity syndrome symptoms:

A
  • Oozing of blood from mucosa
  • Nose bleeding
  • Minor surgical procedures result in prolonged bleeding
  • Disturbance of vision (BV are swollen)
26
Q

Hyperviscosity syndrome treatment

A

Plasmapheresis (dilute their plasma & IgM decreases)

27
Q

Immunofluorescence studies involves staining tissue w/ ___ labeled w/ ___, then tissue biopsy is stained & washed & examined for ___ under a ___ microscope

A

Antibodies
fluorescent dye
specific fluorescence
fluorescent

28
Q

What are the steps for direct immunofluorescence?

A

Tissue biopsy from mouth + add antibody labeled w/ fluorescent dye → then look for specific fluorescence under fluorescent microscope

29
Q

blister like lesion in mouth & lesions on arms & legs is __ disease

A

pemphigus

30
Q

Where is the antibody in pemphigus vulgaris? What type of appearance of the fluorescence in the epithelium does it have?

A

Antibody is against intracellular substances in epidermis
Has an intact mucous membrane

Has chicken wire appearance of the fluorescence in the epithelium

31
Q

Pemphigus & pemphigoid diseases have type ___ hypersensitivity

A

type II

32
Q

Symptoms for pemphigoid disease

A

lesions on mouth, not skin
has a bothersome lesion of the conjuctiva of the eye & no skin involvement

33
Q

Where is the antibody located in pemphigoid disease? Where is the fluorescence located & is it linear or curved?

A

Dermis separated from epidermis at basement membrane
Antibody is against basement membrane

Basement membrane & linear

34
Q

T/F: Pemphigus disease is benign

A

False

Pemphigoid disease is benign

35
Q

Lesion on hands & face are __ disease. It is a type ___ hypersensitivity rxn

A

systemic lupus erythematosus (SLE)

Type III

36
Q

Where are the deposits of immune complexes for SLE? Are they linear or bumpy?

A

Deposits of immune complexes at basement membrane or dermal-epidermal junction

bumpy

37
Q

An ___ test will be positive in patients w/ SLE

A

anti-nuclear antibody test

38
Q

Type II hypersensitivity reactions can be associated w/

A

blood transfusion reaction & hyperacute graft rejections

39
Q

Organ or cell specific autoimmune disease

A
  • Hashimoto’s thyroiditis
  • Pemphigus vulgaris
  • (benign) Mucous membrane pemphigoid (BMMP or MMP)
  • Autoimmune hemolytic anemia
  • Myasthenia gravis
40
Q

Hashimoto thyroiditis antibodies

A

anti-thyroid antibodies

41
Q

Pemphigus vulgaris antibodies

A

Antibodies to intracellular substance of the epithelium

42
Q

(benign) Mucous membrane pemphigoid (BMMP or MMP) antibodies

A

Antibodies to basement membrane

43
Q

Autoimmune hemolytic anemia antibodies

A

antibodies to RBC

44
Q

Myasthenia gravis antibodies ___. What happens?

A

Antibody against Ach receptor

  • Antibody reacts w/ Ach receptors & cause them to go inside cytoplasm or disappear & patient doesn’t have any receptors to react w/ Ach
  • Muscles are weakened

604 Immuno/Microbio - Exam 3 (5 decks)

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