Laboratory Assessment of the Immune System

Question 1

acute phase proteins

Answer 1

CRP
mannose binding lectin
alpha1-antitrypsin
fibrinogen
complement proteins (C3, C4)
haptoglobin
ceruloplasmin

Question 2

T or F. Albumin decreases as APP (acute phase proteins) increases

Answer 2

T

Question 3

increased acute phase proteins

Answer 3

infections = bacterial, viral, parasitic
autoimmune disease
trauma, surgery, burns
tissue infection = myocardial, renal
malignancy
radiation therapy

induced by TNF, IL-6, IL-1 from leukocytes

Question 4

this binds C-polysaccharide of S. pneumonia ando ther bacteria, fungi, and parasites

Answer 4

CRP

Question 5

T or F. CRP can activate complement without Ab

Answer 5

T

Question 6

CRP characteristics

Answer 6

• binds/clear toxins from damaged tissue
• levels rise after oonset of inflamm (4-12 hrs)
• used to monitor inflam and malignancy
• can activate complement without Ab

Question 7

ref range of CRP

Answer 7

<8.0 mg/L

Question 8

CRP vs hsCRP

Answer 8

• high sensitive CRP
• CRP = 8-1000 mg/L
• hsCRP = 0.5-10 mg/L

Question 9

indicator of cardiovascular disease/stroke

Answer 9

hsCRP

Question 10

neutrophil oxidative burst test

Answer 10

• uses PMA, fMLP, DHR123, rhodomine
• uses pt neutrophils
• incubate cells with DHR123 which enters cell
• add mitogen (fMLP), which stimulates NADPH oxidase production
• H2O2 oxidizes DHR123 to Rhodamine = fluorescence!

Question 11

how to measure the increase in fluorescence in the neutrophil oxidative burst test

Answer 11

use flow cytometry

Question 12

lymphs CD

Answer 12

T = CD3
- Th = CD3,4
- Tc = CD3,8

B = CD19

NK = CD16,56

Question 13

qualitative B cell tests

Answer 13

• Ab levels = GAM
• IgG subclass = IgG1,2,3,4
• specific Abs
  > ABO
  > expected Ab titres
  > titre pre/post vaccination
  > IgM and total

Question 14

T or F. T cells are difficult to determine their functionality

Answer 14

T
- they produce IL-2 first thing after getting activated
- measuring response of IL-2 of an active response in a secondary lymphoid tissue is difficult to do in vitro = very short-lived
- also many kind of T cells

Question 15

in vivo tests for T cells

Answer 15

delayed type hypersensitivity test

Question 16

sensitization phase of delayed type hypersensitivity test

Answer 16

activation of Th1 cells
= Th17, Tc, NK cells

Question 17

effector phase of delayed type hypersensitivity test

Answer 17

antigen exposure = Th1 secrete IFN-y, TNF-B, also activate monocytes to tissues (MACROPHAGES), neutrophils

= raised red bump

Question 18

example of DTH test

Answer 18

skin test = purified protein derivative (PPD) tuberculin injected under skin
= 48-72 hr response
- pos = exposure to tuberculosis or vaccine

Question 19

DTH - Th function test

Answer 19

• finds out if T cells are for sure working
• uses recall antigen
  > Tetanus toxoid
  > C. albicans
  > MMR
  (Use something that WE KNOW we’ve been in contact with)

Th1 cells release cytokines = MO/macrophage, neutrophils respond

Question 20

CH50 test

Answer 20

requires all components to function
- liposomes contain G6PD
- dinitrophenol on liposome (DNP)
- anti-DNP reagent
- NAD + G6P reagent
- pt plasma = source of complement
- when pts plasma forms MAC, it releases G6PDH
- measure absorbance of NADH at 340 nm