Lab Assessment of Immune Function Flashcards
IFN function
glycoprotein that activates Mf
Lysosomes function
attacks bacterial cell walls
Complement function
multiple proteins that undergo a cascade of events that end in cell lysis, opsinization, and inflamm.
How is the classical complement pathway activated?
when IgM or IgG abys bind Ag
How is the lectin complement pathway activated?
Mannose binding protein binds to Ag
How is the alternative complement pathway activated?
does not require the presence of abys or lectines, binds to cell surface, continuously activated at low levels
what does OIL stand for?
The ways in which complement induces cell destruction.
O- opsonization: flags it for Mf so it can be easily seen. “yummy”
I- inflamm: release histamine inc erase blood vessel permeability and attracts phagocytes
Lysis: breakdown destruction of cell membranes, bores holes cause cell leakage
Major goal of complement?
deposit C3 fragment on target.
MAC is made up of which complement proteins?
C3a, C4a, C5
Why do we measure complement?
- recurrent infection w/ normal WBC & no immunosuppression
- to diagnose Auto-antibody-mediated immune syndromes
- to diagnose immune-complex-mediated syndromes (lupus, glomerulonephritis)
What is glomerularnephritis?
would your complement levels be high or low? why?
Ag-aby complexes clump up in the nephrons and shred blood cells—brown urine
low levels because your complement is continually being consumed.
Screening test for classical and alternative pathway?
classical-CH50
alternative- AH50
If you are having recurrent upper respiratory infections which Ig might you be deficient of?
IgA
Difference between CBC w/ DIff and CBC w/ peripheral smear
CBC w/ diff is just the number of counts of each white cell present
Smear- when pathologist looks at the cells instead of a machine
When do you order a CBC w/ peripheral smear?
When CBC w/ Diff are abnormal
Macrocytic vs Microcytic Anermia caused by?
Micro- Iron deficiency
Macro- Folate and B12 deficiency
Neutrophils/Bands
AKA: PMNS
first to arrive
50-60% of total blood cells
arrives within 90mins
phagocytic cell
total neutrophil count will increase during acute inflamm response
Other sources of increased neutrophils:
- stress
- exercise
- steroids (prednisolone)
Bands are horse-shoe shaped less mature neutrophils– if you see these you know infection is really bad
What is a “shift to the left”
bad infection, recruiting (increased) baby neutrophils to help fight infection
-seen in acute appendicitis or cholecystitis
Most infections stimulate neutrophil production, though some decrease their production, what are these?
What meds cause neutropenia?
neutropenia cause by hepatitis, influenza, rubella, rubeola, mumps
meds- TCA and some abx
Increase in eosinophils d/t?
Decrease?
increase- allergy
decrease- corticosteroid drugs
Basophils release what mediators during inflammation?
What are they called in tissues?
heparin, histamine, serotonin
mast cells
What disease may cause increase in basophils?
Decrease?
increase-Hodkins lymphoma, leukemia
decrease- Coritcosteroid drugs, allergic rxns, acute infections
Phagocytic Monocytes produce what antiviral substance?
IFN
*bodys 2nd line of defense
What disease may cause monocystosis (increased monocytes)
TB, malaria, rocky mountain fever, spotted fever, monocyte leukemia, chronic ulcerative colitis
Why might lymphocytes be beneficial or detrimental?
beneficial when they can remember ag and eat them up when they invade the body but the cells are not destroyed afterwards they still circulate throughout the body, ag in the lymphocyte can kind of hide out in the body for years
lymphocytosis- think viral infection
What may cause an increase/decrease in lymphocytes ?
increase- viral infection and TB
decrease- corticosteroids, immunosuppressive drugs, chemo
> 500cells= very high risk of infections
Normal range WBC count
4,500-11,000 cells/cm2
Differential: 45-75% neutrophils
20-45% lymphocytes
What is the cause of an increased number of….
neutrophils
eosinophils
basophils
lymphocytes
N- bacterial infection, steroids
E-parasites and allergy
B- allergy
L-viral infection and malignancy
Review Case Study
slide 37-39
What cell count constitutes neutropenia?
Causes?
What cell count constitutes lymphocytopenia?
Causes?
Absolute lymphocyte count (ALC)
Polyclonal definition
multiple plasma cells produce hetergeneous abys
Monoclonal Definition
plasma cells derived from a single Ag stimulated Bcell, produce homogenous abys
serodiagnostic testing:
Direct immunoassays detect _______.
uses in real life
the presence of Ags.
- rapid strep test
- pregnancy tests
serodiagnostic testing:
ELISA detect _______.
uses in real life
detects aby and/or ag in sample
-HIV
serodiagnostic testing:
Indirect immunoassays detect _______.
uses in real life
if pt abys are present with the Ag provided
- HIV
- Mono
- Hep A, B, C
Agglutination
interaction of Ag with aby leads to agglutination.
Disease may be diagnosed this way.
DIrect Agglutination
test patient serum against large cellular ag to screen for abys
Indirect Agglutination
two forms of indirect agglutination:
1.) Insert latex bead w/ Ags attached to see if serum contains abys that will cause aggultination of latex beads
2.) Insert latex beed w/ Abys attached to see if serum contains Ags that will cause agglutination of latex beads
.
Serum Protein Electrophoresis (SPEP) diagnosis what disease?
multiple myeloma and hypogammaglobulinemia
Types of Skin testing
Cutaneous Delayed-Type Hypersensitivity
Qualitative functional Assay (ID injection of ag)- check in 24-48hrs
Anergy
lack of skin reactivity»>depressed Cell mediated immunity
