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PCD Flashcards

1
Q

mature B cell capable of synthesizing antibodies

A

PLASMA CELL

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2
Q

are proteins with gamma electrophoretic mobilities that are synthesized in response to an antigen

A

ANTIBODIES (IMMUNOGLOBULINS or g GLOBULINS) –

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3
Q

Activators of classical complement pathway

A

IgG

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4
Q

Hemaglutinins

Hemolysins

A

IgG

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5
Q

Most common (80%)

A

IgG

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6
Q

Precipitating antibody

Virus-neutralizing antibody

A

IgG

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7
Q

Synthesized by plasma cells found in the respiratory and GI tracts and most excretory organs

A

IgA

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8
Q

First line of defense for mucosal surfaces

A

IgA

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9
Q

Second most abundant (10-15%)

A

IgA

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10
Q

First antibody to appear in response to an antigenic challenge

A

IgM

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11
Q

Circular pentameric arrangement

A

IgM

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12
Q

Largest antibody

A

IgM

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13
Q

5-10% of circulating antibodies

Localized in blood

A

IgM

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14
Q

“Ragweed” antibody

A

IgD

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15
Q

Trace concentrations

A

IgD

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16
Q

MW = 140,000 daltons

A

IgD

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17
Q

Functions in lymphocytic activation and suppression

A

IgD

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18
Q

Mediates allergic reactions and parasitic infections

A

IgE

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19
Q

Attaches to mast cells and basophils

A

IgE

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20
Q

“Reagenic antibody”

A

IgE

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21
Q

detects imbalance of Ig of free H or L chains

A

IMMUNOELECTROPHORESIS and IMMUNOFIXATION ELECTROPHORESIS

22
Q

Most common disease of plasma cells

A

MULTIPLE MYELOMA

23
Q

MULTIPLE MYELOMA

Predisposing factors

A

Genetics

Chronic antigenic stimulation

24
Q

Begins in the bone marrow with lytic bone diseases and osteoporosis

A

MULTIPLE MYELOMA

25
Q

Igs produced are mostly of the _ class (50%) or _ (20%) or L-chains only __ (15%) or _ (25%)

A

IgG
IgA
(Bence-Jones Protein)
Amyloid

26
Q

CLINICAL PRESENTATION

A

HyperCalcemia
Renal insufficiency
Anemia
Bone lesions

27
Q

LABORATORY FINDINGS

A

N/N anemia

ESR elevated due to increased globulins

Rouleaux formation

Few abnormal plasma cells

BM = 10-15% plasmacytes

Urinary protein (strip and SSA) – not sensitive due to their specificity to albumin

(+) casts – hyaline or tubular epithelial casts

Electrophoresis – monoclonal peak

Hyperuricemia

Hypercalcemia

Radiologic exams

28
Q

MYELOMA CELL CHARACTERISTICS

A

Large with immature appearing chromatin OR small with clumped chromatin

Pale or dark (depending on cytoplasmic RNA)

Sometime bizarre and multinucleated or lobulated nuclei

Inclusions

29
Q

Accumulations of Igs in the cisternae

A

MOTT CELL, MORULA CELL or PLASMA CELL WITH RUSSELL BODIES

30
Q

intranuclear inclusions

A

DUTCHER BODIES –

31
Q

Circulating plasma cell levels > 2 X 109/L (0.14-0.20 NV)

A

PLASMA CELL LEUKEMIA

32
Q

PLASMA CELL LEUKEMIA

A

Younger patients

Less bone pain

Less osteolysis

Greater incidence of lymphadenopathy and hepatosplenomegaly

Pancytopenia with
leukoerythroblastic findings

Elevated ESR

Abnormal plasma cells are smaller with little cytoplasm and pronounced N:C asynchronism

BM infiltration is diffuse (45%)

33
Q

A lymphoproliferative disorder characterized by large concentrations of monoclonal IgM (>15%)

A

WALDENSTROM MACROGLOBULINEMIA

34
Q

The abnormal B lymphocytes arise from the extramedullary nodes and have the ability to differentiate to large plasmacytoid lymphocytes and plasma cells

A

WALDENSTROM MACROGLOBULINEMIA

35
Q

Rarely causes osteolytic lesions

A

WALDENSTROM MACROGLOBULINEMIA

36
Q

Glomerular lesions caused by deposition of IgM complexes of amyloid

A

WALDENSTROM MACROGLOBULINEMIA

37
Q

Affects men >50 years old with hepatosplenomegaly, lymphadenopathy and retinal abnormalities

A

WALDENSTROM MACROGLOBULINEMIA

38
Q

WALDENSTROM MACROGLOBULINEMIA

LABORATORY FINDINGS

A

N/N

Reticulocytes dec. or N

Normal WBC and platelets

BM- plasmacytoid lymphoma
(+) Mast cells – CLUE!

39
Q

Autoimmune hemolytic anemia

A

Raynaud’s phenomenon (anti-G)

Cold agglutinin (anti-i)

40
Q

WALDENSTROM MACROGLOBULINEMIA

platelet function

fibrinogen

thrombin time

plasma viscosity

Monoclonal IgM with cryoglobulin activity

A

Abnormal platelet function

Thrombocytosis (maybe plasma precipitates)

Low fibrinogen

Prolonged thrombin time

Increased plasma viscosity

– precipitation or gel formation at 4C

Electrophoresis

41
Q

A rare disease characterized by abnormal synthesis of Fc fragment of a particular H chain particularly a (most common), g and m

A

HEAVY CHAIN DISEASE

42
Q

Resembles activated lymphocytes and plasma cell

Lymphoma like symptoms

A

HEAVY CHAIN DISEASE

43
Q

HCD

characterized by infiltration of plasmacytoid lymphocytes into the duodenal and jejunal walls producing malabsorption and abdominal distress and respiratory tracts

44
Q

HCD Found in older men and presents with a malignant lymphoma with fever, erythema, lymphadenopathy and hepatosplenomegaly

45
Q

HCD Rarest; associated with CLL

46
Q

A condition in which proetinaceous deposits (amyloid) occur throughout the body

A

AMYLOIDOSIS

47
Q

closely associated with monoclonal gammopathies such as plasma cell myeloma

A

PRIMARY AMYLOIDOSIS

48
Q

associated with chronic illnesses and amyloid unrelated to Ig

A

SECONDARY AMYLOIDOSIS

49
Q

AMY Electron microscopy and Xray diffraction

A

amyloid is in the Beta pleated sheet formation

50
Q

AMY Polarizing microscopy with Congo red

A

apple green birefringence

HEMA2 (17 decks)

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