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Tao Le A/I Board Review > Laboratory Tests > Flashcards

Laboratory Tests Flashcards

1
Q

How does nephelometry determine amount of antibody?

A

Scatter light used to determine turbidity created by immune complexes - automated, method of choice

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2
Q

How does Radial immunodiffusion (RID) determine amount of antibody?

A

Antiserum mixed in gel with study Ig, look for ring of precipitation - time consuming

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3
Q

How does the Laurel Rocket determine amount of antibody?

A

Immunodiffusion + electrophoresis - takes minutes but insensitive, semiquantitative

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4
Q

What test can be used to detect both antibody and antigen excess?

A

ELISA

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5
Q

How are proteins separated for western blot?

A

electrophoresis

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6
Q

What method is used to confirm monoclonal gammopathy and heavy or light chain class type?

A

Immunofixation electrophoresis

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7
Q

At what age is the nadir for IgG, when maternal IgG is waning and child has not yet started producing IgG?

A

6 months

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8
Q

Which assay is used to detect antigen specific IgE antibody using chemiluminescent ELISA?

A

DPC Immunlite

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9
Q

What test is used to diagnose Lyme’s disease and which is used for confirmation

A

ELISA to screen, western blot to confirm

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10
Q

Which leukotrienes are used to detect basophil activation and how are they detected?

A

LTC4, LTD4, LTE4 detected with ELISA

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11
Q

Which marker on flow cytometry is used to determine basophil activation?

A

CD63

BAT high sensitivity, low specificity

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12
Q

What method is used to detect interleukins?

A

ELISA

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13
Q

What method is used to detect prostaglandins

A

radioimmunoassay (RIA)

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14
Q

What methods are used to detect presence of TLRs?

A

RT-PCR; flow cytometry (intracellular)

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15
Q

What method is used to determine TLR function?

A

incubation with panel of ligands for TLR1-9, measure release of inflammatory molecules with ELISA, Flow, or PCR

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16
Q

What method is used to detect bradykinin?

A

radioimmunoassay (RIA)

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17
Q

Where is CD1 found and what is its function?

A

APCs; presents bacterial lipid antigen to T cells

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18
Q

Where is CD2 found and what is its function?

A

NK and early T cells; activates T cells, mediates adhesion between T cell and APC, inhibits apoptosis

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19
Q

Where is CD3 found and what is its function?

A

T cells (NOT NK CELLS!); required for TCR signal transduction; defect causes SCID

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20
Q

What monoclonal antibody targets CD3 and is used in solid organ transplant and ALL?

A

OKT3

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21
Q

Where is CD14 (LPS receptor) found and what is its function?

A

macrophages and monocytes; PAMP - detects lipoteichoic acid, mediates IL-12 and IFNγ production

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22
Q

Where is CD16 found and what is its function?

A

NK cells, neutrophils; most common IgG receptor for phagocytosis

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23
Q

Where is CD18 found and what is its function?

A

neutrophils; adhesion and signaling

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24
Q

Where is CD19 found and what is its function?

A

B cells; coreceptor with CD21; B cell activation

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25
Q

Where is CD20 found and what is its function?

A

B cells; transmembrane receptor needed for B cell activation

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26
Q

Where is CD21 found and what is its function?

A

Mature B cells; binds to CD23 and viruses

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27
Q

Where is CD22 found and what is its function?

A

B cells; inhibits B cell signialing

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28
Q

Where is CD23 found and what is its function?

A

mature B cells; B cell activation

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29
Q

Where is CD25 (IL-2 Rα) found and what is its function?

A

Activated B and T cells; suppression of NK cells & self-reactive T cells - elevated in HLH

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30
Q

Where is CD27 found and what is its function?

A

memory B cells; marker of B cell activation (memory B cells are CD27+ and memory T cells are CD27-)

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31
Q

Where is CD32 found and what is its function?

A

WBCs, binding of FcγRII proposed mechanism for IVIG

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32
Q

Where is CD35 found and what is its function?

A

WBCs; binds immune complexes coated with C3b and C4b

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33
Q

Where is CD40 found and what is its function?

A

APCs; T cell dependent Ig switching of B cells - defective in hyper IgM3

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34
Q

Where is CD45 found and what is its function?

A

naive, memory or activated T cells; defective in T-B+NK- SCID

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35
Q

Which cell marker is the receptor for adenovirus?

A

CD46

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36
Q

Which cell marker is the target of alemtuzumab used to treat CLL?

A

CD52

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37
Q

Which cell marker is the receptor for rhinovirus?

A

CD54 (ICAM-1) and LDL receptor

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38
Q

Which cellular marker is deficient in paroxysmal nocturnal hemoglobinuria?

A

CD55

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39
Q

Which cellular markers are defective in LAD2 and where are they located?

A

E-selectin on endothelium; P-selectin on platelets

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40
Q

Which cellular marker is used for lymphocyte homing to HEV of lymph nodes?

A

L-selectin

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41
Q

What is the function of CD64?

A

HIGH affinity receptor for IgG needed in ADCC

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42
Q

What is the CD marker for CD40L and where is it found?

A

CD154 found on T cells - defective in XHIGM

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43
Q

Which cellular marker is defective in ALPS?

A

CD95 (Fas)

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44
Q

What is the CD marker also called FasL?

A

CD178

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45
Q

CD28 binds to what for costimulation during T cell activation?

A

CD80 (B71) and CD86 (B72)

46
Q

An activating mutation in CXCR4 causes what?

A

phagocytic defect, leads to WHIM - wart, hypogam, infection and myelokathexis

47
Q

CCR5 and CXCR4 are coreceptors for which virus?

A

HIV

48
Q

This is the most potent complement receptor and binds iC3B and ICAM-1

A

CR3

49
Q

Which PID is associated with defective CD40 and which has defective CD40L?

A

hyper IgM3; x-linked hyper IgM

50
Q

Chemokine receptor CCR3 is implicated in allergic disease and binds to which ligands?

A

CCL11 (eotaxin-1), CCL26 (eotaxin-3), CCL5 (RANTES -Regulated on Activation, Normal T Expressed and Secreted)

51
Q

This chemokine receptor functions in cell trafficking, is a coreceptor for HIV, and binds CCL5 (RANTES -Regulated on Activation, Normal T Expressed and Secreted)

A

CCR5

52
Q

This chemokine receptor functions in T cell trafficking and binds to CCL17 (TARC).

A

CCR4

53
Q

This chemokine receptor functions in naive T cell and DC trafficking to lymph nodes and binds to CCL21 (SLC)

A

CCR7

54
Q

This chemokine receptor functions in B cell development and is an HIV coreceptor

A

CXCR4

55
Q

This cell marker on T cells mediates homing to skin

A

CLA-1

56
Q

Which surface marker is present on memory B cells and absent on memory T cells?

A

CD27

57
Q

This cell marker on T cells mediates homing to colon

A

A4β7

58
Q

Which surface marker would differentiate a memory T cell from a Naive T cell

A

CD45RO

59
Q

Which B cell surface marker is inhibitory?

A

CD22

60
Q

Which surface marker would indentify a mast cell?

A

CD117 (c-KIT)

61
Q

What is the difference in function between conventional and plasmacytoid dendritic cells?

A

conventional are APCs, plasmacytoid produce IFNα

62
Q

A CD3+ CD25+ cell on flow would indicate what?

A

T reg or activated T cell

63
Q

How is a lymphocyte proliferation assay stimulation index performed?

A

Incubate with mitogen and radioactive tritiated thymidine - this is incorporated into dividing cells’ DNA, then measure radioactivity

64
Q

How is flow based T lymphocyte proliferation assay performed?

A

PBMCs labeled with fluorescent dye, stimulate cells with mitogen, measure fluorescence

65
Q

During what part of B cell development is CD20 present?

A

pre-B and B cell blasts

66
Q

What is the mutation in X-linked agammaglobulinemia?

A

Bruton’s tyrosine kinase

67
Q

What abnormality is seen on flow cytometry in X-linked agammaglobulinemia?

A

absence of CD19 B cells

68
Q

What type of B cell is CD27- and IgD+?

A

Naive B cell

69
Q

What type of B cell is CD27 + and IgD+?

A

Activated, unswitched B cell

70
Q

What type of B cell is CD27+ and IgD-?

A

Memory B cell

71
Q

Which mitogens stiumlate T cells?

A

Pokeweed, phytohemagglutinin, concanavalin A

72
Q

Which mitogens stimulate B cells?

A

Pokeweed, LPS, SAC

73
Q

What is measured in determining NK cell function?

A

Perforin, Granzyme, CD107a expression

74
Q

In patients with hemophocytic lymphohistiocytosis (HLH), expression of what is found to be deficient on flow?

A

perforin, granzyme

75
Q

Which surface markers are not present in LAD1?

A

CD18 (part of Mac complex with CD11b)

76
Q

What is characterized by neutropenia, recurrent skin, sinus, pulm infxns, oculocutaneous albinism, MR and neuropathy?

A

Chediak-Higashi syndrome

77
Q

Chediak-Higashi syndrome is due to a mutation in what?

A

LYST 1q42

78
Q

Myeloperoxidase deficiency is usually asymptomatic. What types recurrent infections are reported in diabetic?

A

candida of skin bones and blood

79
Q

Mutations in the NADPH oxidase system leads to what?

A

CGD

80
Q

The NBT reduction tests assesses neutrophil function. How is this accomplished?

A

Neutrophils mixed with yellow dye. Normal oxidative burst will reduce dye, making it blue. Qualitative measure. NOT THE GOLD STANDARD

81
Q

The DHR test is a quantitative measure of neutrophil function, How does it work?

A

nonfluorescent dye taken up by neutrophils, converted to fluorescent compound by NADPH, assessed by flow

82
Q

What is the advantage of the DHR test over other assessments of neutrophil function?

A

It can distinguish between X-linked, autosomal and x-linked carriers for CGD

83
Q

A DHR assay with a low, broad peak would indicate what?

A

AUTOSOMAL gp-47 (phox) deficient CGD

84
Q

A DHR assay with almost no response would indicate what type of defect?

A

X-LINKED gp-91 (phox) deficient CGD

85
Q

Monoclonal antibodies ending in -omab are derived from what?

A

mouse

86
Q

Monoclonal antibodies ending in -ximab are derived from what?

A

chimera - combines murine mAb variable region with constant region of human Ab

87
Q

Monoclonal antibodies ending in -zumab are derived from what?

A

humanized

88
Q

Monoclonal antibodies ending in -umab are derived from what?

A

human

89
Q

Monoclonal antibodies ending in -cept are derived from what?

A

fusion proteins - created by joining 2 or more genes that originally coded for separate proteins

90
Q

When IgG or IgM bind to normal human cells, what inhibits immune complex formation and how?

A

Factor H and I inhibit conversion of C3b to iC3b

91
Q

What determines the size of an immune complex?

A

the degree of antigen or antibody excess

92
Q

What can be measured to monitor disease burden from immune complexes in SLE?

A

C3 and C4 (complement consumption)

93
Q

What is the most common cause of a low complement level?

A

poorly handled specimen

94
Q

AH50 assesses what?

A

alternative complement pathway

95
Q

CH50 assesses what?

A

classical complement pathway

96
Q

How is the MBL complement pathway assessed?

A

ELISA - incubate serum with mannan, measure C4b and C4d

97
Q

What is used as a marker for activation of the classical or lectin complement pathway?

A

C4a and C4d

98
Q

What is a marker of activation of the alternative complement pathway?

A

Bb

99
Q

Which type of angioedema has low C1q levels?

A

acquired angioedema

100
Q

Which type of angioedema has normal or elevated levels of C1 inhibitor?

A

HAE type II

101
Q

C1q autoantibody is present in which type of vasculitis?

A

hypocomplementemic

102
Q

What complement defect would be expected in an individual with recurrent neisseria infections?

A

Terminal complement components (C5-9)

103
Q

Mutations in genes coding for what have been associated with type III HAE?

A

Factor 12 (Hageman Factor) - usually gain of function

104
Q

How are TRECs measured?

A

PCR

105
Q

What happens to the amount of TRECs as someone ages?

A

declines

106
Q

What type of infection is associated with decreases in TRECs?

A

HIV-1

107
Q

Reverse transcriptase (RT) PCR is used to detect what?

A

mRNA expression levels

108
Q

When is RT-PCR used?

A

to detect viruses with genomes composed of RNA such as HIV and influenza A

109
Q

What type of assay would you use to fund specific features of DNA for use in genetic counseling, medicine and species identification?

A

FISH

110
Q

What lab technique is used to diagnose ALL, DiGeorge and Down syndrome?

A

FISH

111
Q

What are gene chips used for?

A

sequencing large numbers of genes to identify SNPs

Tao Le A/I Board Review (11 decks)

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