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TT BL and DD Exam1 > Practice test review > Flashcards

Practice test review Flashcards

1
Q

What is the antigenic determinant region?

A

It is the epitope of the antigen that binds lymphocyte receptors at the hyper variable region

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2
Q

Allotype

A

minor allelic differences in the sequence of Igs between individuals, determined by allotypes of your parents, useful in determining relatedness

-Usually result from substitution of only one or two amino acids in the constant region usually of heavy or light chains

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3
Q

Isotype

A

The class of an antibody heavy or light chain, IgM ,IgE IgA are examplesof different isotypes

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4
Q

Idiotype

A

unique combining region, made up of the CDR amino acids of its L and H chain, that each antibody has

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5
Q

Immunogen

A

a form of antigen that actually produces an immune response.

○ Ie: taking a skin biopsy and putting it on another person. Will react with their immune system, but not yours.

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6
Q 
Normal WBC for:
Neutrophil:
Eosinophil:
Basophil:
Monocyte:
Lymphocyte:
A 
Neutrophil: 40-60%
Eosinophil:1-4%
Basophil: 0.5-1%
Monocyte: 2-8%
Lymphocyte: 20-40%
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7
Q

Where is B12 absorbed in the body?

A

terminal ileum

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8
Q

Where is folate absorbed in the body?

A

jejunum

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9
Q

Which thalassemia ALWAYS requires transfusions?

A

B-thal major (cooleys anemia)

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10
Q

Would you expect a high or low level of homocysteine in B12 and folate deficiency? Why?

A

High homocysteine:

homocysteine - cant be converted to methionine or cysteine w/ B12 or folate -> builds up

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11
Q

Would you expect a high level of methylmalonic acid in folate deficiency? Why?

A

No. it should be normal.

You are not deficient in B12 -> MA is converted to tetrahydrofolate -> doesnt build up like it would in B12 deficiency

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12
Q

Is warm antibody-induced autoimmune hemolytic anemia (AIHA) extravascular or intravascular hemolysis? What antibodies are they mediated by?

A

extravascular, IgG antibodies

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13
Q

Hemoglobin H contains which chains (how many alpha, beta, ect.)?
-due to what?

A 
4 beta
(tetramer of beta  due to 3 alpha gene deletion)

milder than beta thal*

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14
Q

Hemoglobin Barts contains which chains (how many alpha, beta, ect.)?
-due to what?

A

4 gamma chains due to under production of alpha globin

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15
Q

Is hemolysis associated w/ high or low levels of haptoglobin? Why?

A

Low levels
rbc lyse -> free hemoglobin binds haptoglobin -> hemoglobin-haptoglobin complex is clears quickly by the liver -> low or undetectable haptoglobin levels.

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16
Q

Is hemolysis associated w/ high or low levels of LDH? Why?

A

RBC rupturing->released hb converted to unconjugated bili-> high bili > high LDH

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17
Q

An increase in what things are going to shift the oxygen dissociation curve LEFT? What does that indicate?

A

pH

left shift = oxygen is held tighter = favors O2 loading (not unloading)

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18
Q

An increase in what 3 things are going to shift the oxygen dissociation curve RIGHT? What does that indicate?

A

Temp, CO2, 2-3, BPG

right shift = oxygen affinity lower = favors O2 unloading

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19
Q

How do you calculate MCV?

A

MCV = HCT / RBC

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20
Q

How do you calculate HCT?

A

HCT = RBC x MCV
or
HCT ~ 3x Hb

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21
Q

How do you calculate MCH?

A

MCH = HGB / RBC

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22
Q

What is marrow cellularity?

how do you calculate it?

A

how much of marrow is hematopoietically active?

Should be 100 - Age:
ie 75% cellularity for 25 year old.

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23
Q

What test do you use for hereditary spherocytosis? Why?

A

osmotic fragility test

spherocytes lyse at a higher osmolarity than RBC’s

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24
Q

High levels of neutrophils can be due to what 2 things?

A

neoplastic (CML)

reactive (leukemoid rxn secondary to disease)

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25
Q

What is normal Absolute neutrophil count (ANC)?

A

> 1500

or 1500-8000/mm3 or 1.5-8.0

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26
Q

Within one immunoglobulin molecule there might be 2 types of light chain. T or F?

A

False

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27
Q

Allotypic exclusion

A

single B cell can synthesize only 1 H chain (maternal or paternal in origin) and only 1 L chain (maternal or paternal, kappa or lambda)

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28
Q

Why are protein and killed vaccines given early; live virus vaccines after a year.

A

protein Ags work in newborns so give them early

live viruses (which have to grow in the vaccine before they achieve an immunogenic dose) have to wait until there is no residual maternal Ab.

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29
Q

The primary cell type in a germinal center in a lymph node follicle in the cortex is?

A

B cell.

Thats why the tfh migrate into the follicles of the cortex. Where B cells are abundant

30
Q

How many polypeptide chains does IgA have? Explain

A

10 polypeptide chains:

4 light, 4 alpha (heavy) chains, 1 Joining chain and 1 Secretory component

31
Q

How many polypeptide chains does IgG have? Explain

A

4

2 light and 2 gamma (heavy) chains

32
Q

How many polypeptide chains does IgE have? Explain

A

4

2 light and 2 epsilon (heavy) chains

33
Q

How many polypeptide chains does IgD have? Explain

A

4

2 light and 2 delta (heavy) chains

34
Q

How many polypeptide chains does IgM have? Explain

A

21

10 light, 10 mu and 1 joining chain

35
Q

Valence refers to the number of antigenic determinants an antibodymolecule can theoretically bind. What is the valence of IgG? of secreted IgA? of IgM? of Fab? of F(ab2)?

A

count the dual tips*

IgG - 2
secretory IgA - 4
IgM - 10
Fab - 1
Fab2 - 2
36
Q

The part of antibody molecules that contacts the antigenic determinant

A

the hypervariable region of antibody (light/heavy chain)

37
Q

Can immunogens always be considered antigens?

A

Yes, bc they actually produce immune response,

but not all antigens are considered an antigen for someone else

38
Q

Fab can bind what?

A

1 fab binds 1 antigen.
2 fabs binds 2 antigens
but no agglutination will be seen.

39
Q

Do T cell mediated immunity involve plasma cells? Why or why not?

A

No. T cells will interact w/ B cells, which then go on to differentiate into plasma cells.

40
Q

Fc of IgE adheres to which cells? What happens?

A

Mast cells and basophils -> trigger histamine release -> immediate hypersensitivy/allergy

41
Q

Somatic hypermutation

A

Recombined V(D)J unit is “hypermutable”

Each time B cell divides (after antigenic stimulation, so somatic): good chance that 1 of daughters will make slightly diff. antibody

-not T cells!

42
Q

Which complement is opsonizing for polymorphonuclear neutrophils (PMNs) ?

A

C3b

so that means that the PMNs will have a firm grip on the antigen if it is opsonized w/ c3b

43
Q

Which complements are lytic for polymorphonuclear neutrophils (PMNs) ?

A

○ Membrane attack complex (MAC) is activated when C5 activates C6-C7-C8-C9.

○ C8 and C9 form a lesion on the target cell membrane (looks like a hole)

44
Q

Which complements are anaphylatoxic for polymorphonuclear neutrophils (PMNs) ?

A

C3a, C4a and C5a can all release histamine from mast cells or basophils

45
Q

Which complements are chemotactic for polymorphonuclear neutrophils (PMNs) ?

A

C5a

*hallmark

46
Q

myeloid

A

arises from cell type in marrow (everything that isnt lymphoid)

47
Q

% of myeloid cell types in WBC

% lymphoid

A
  1. Neutrophils 60%
    1. Monocytes 5%
    2. Eosinophils <1%
      1. lymphocyte 20-40%
48
Q

Which part of the membrane attack complex polymerizes in the membrane to form a transmembrane channel?

A

C9

49
Q

A single B cell switches from making IgM anti-measles to IgG anti-measles. Are the heavy or light chains changed during this switch?

A

Heavy chains are changed during the switch.

mu, delta, gamma, epsilon, alpha

50
Q

Can IgG neutralize viruses? Can it be actively transported into external secretions such as saliva?

A

yes - neutralize virus

no - saliva

51
Q

Central lymphoid organs

  • in humans
  • in birds
A

hu: BM and thymus
birds: bursa of fabricius

52
Q

Can you make antibodies to something that isnt a protein?

A

yes

53
Q

Clonal deletion

A

is a process by which B cells and T cells are deactivated after they have expressed receptors for self-antigens and before they develop into fully immunocompetent lymphocytes

54
Q

Is it possible to see surface IgD, surface IgM, surface Class I MHC, and surface Class II MHC—all on the same cells?

A

yes - perfectly normal

55
Q

F + S, no A

indicative of what?

A

Sickle cell anemia or

HbS β-thalassemia

56
Q

F + A + Bart’s

indicative of what?

A

Hb H disease

57
Q

Spectrin defect = high or low reticulocyte index? MCV??

A 
high reticulocyte
low MCV (along w/ hgb and hct)
58
Q

How do you calculate ANC?

A

total WBC x neutrophil %

Check units!

59
Q

The majority of iron in the body is normally contained in:

A

Hemoglobin

60
Q

Which form of anemias will lead to hypersegmented neutrophils?

A

B12 and folate deficiency (pancytopenia)

61
Q

B12 is required for the function of which two different enzymes?

A
  1. methylmalonyl-CoA mutase, -which converts methylmalonyl CoA –> succinyl CoA
  2. methionine synthase,
    - which converts homocysteine and 5-methyl-tetrahydrofolate –> methionine and tetrahydrofolate
62
Q

B12 affects function of 2 enzymes. What products will build up if there is a B12 deficiency?

A

B12 deficiency will lead to increased levels of both:

  1. serum methylmalonic acid
  2. plasma homocysteine
63
Q

Folate is required for the function of which enzyme?

A

methionine synthase,

- which converts homocysteine and 5-methyl-tetrahydrofolate –> methionine and tetrahydrofolate

64
Q

Folate affects function of 1 specific enzymes. What products will build up if there is a folate deficiency?

A

plasma homocysteine

(methionine synthase,
- which converts homocysteine and 5-methyl-tetrahydrofolate –> methionine and tetrahydrofolate)

65
Q

You are presenting your patient with anemia to your attending on morning rounds, and she asks you if the patient has hypochromia. To answer her question, you tell her the patient’s: (what cbc value?)

A

MCH:

which tells you the average amount of hemoglobin per RBC.

66
Q

cold AIHAs are mediated by what? how is this different from warm?

A

activation of complement

Warm AIHAs are mediated by IgG

67
Q

What are the cells in the bone marrow from which platelets are derived.

A

Megakaryocytes

68
Q

what are the chains found in HbA2? HbF?

A

HbA2? two alpha and two delta chains (α2δ2)

HbF? two alpha and two gamma chains α2γ2

69
Q

Would you have increased or decreased plasma haptoglobin in hemolysis? Why?

A

The hemoglobin-haptoglobin complex is cleared quickly by the liver, leading to low or undetectable haptoglobin levels

70
Q

erythrocytosis

A

increase in the number of circulating RBC, (increased hematocrit)

71
Q

If you lack a 2,3-BPG binding site, describe how a pt. becomes plethoric

A

Hb higher O2 affinity → ↓ O2 tissue delivery → erythrocytosis (elevated RBC) →increased erythropoiesis → increased red cell count, plethoric (red-appearing)

72
Q

Is acute renal failure or splenic sequestration a common manifestation in acute sickle cell anemia ?

A

Splenic sequestration.

renal failure is more chronic than acute

TT BL and DD Exam1 (23 decks)

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