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AMT MT Exam > Review Cards - Immunology > Flashcards

Review Cards - Immunology Flashcards

1
Q

Proteins that increase due to infection, injury, trauma (e.g., C-reactive protein, alpha-1 antitrypsin, haptoglobin, fibrinogen, ceruloplasmin, alpha-1 acid glycoprotein, complement)

A

Acute phase reactants

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2
Q

Antibody formed in response to antigen from individuals of same species

A

Alloantibody

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3
Q

Foreign substance that can stimulate antibody production; most often a large, complex molecule (MW = >10,000), usually protein or polysaccharide

A

Antigen

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4
Q

Immunoglobulin produced by plasma cells in response to an antigen

A

Antibody

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5
Q

Antibody against self

A

Autoantibody

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6
Q

Strength of bond between antigen & antibody

A

Avidity

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7
Q

Cytokines that attract cells to a particular site; important in the inflammatory response

A

Chemokines

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8
Q

Migration of cells toward chemokine

A

Chemotaxis

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9
Q

Antigenic features of leukocytes

A

Clusters of differentiation (CD)

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10
Q

Chemicals produced by activated immune cells that affect function of other cells; includes interferons, chemokines, tumor necrosis factors, transforming growth factors, colony stimulating factors, interleukins

A

Cytokines

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11
Q

Determinant site on antigen

A

Epitope

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12
Q

Low molecular weight substance that can bind to antibody once it’s formed, but is incapable of stimulating antibody production unless bound to a larger carrier molecule

A

Hapten

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13
Q

Heightened state of immune responsiveness that can cause tissue damage in host

A

Hypersensitivity

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14
Q

Resistance to infection

A

Immunity

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15
Q

Any substance capable of inducing an immune response

A

Immunogen

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16
Q

Antibody

A

Immunoglobulin

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17
Q

Cellular & humoral mechanisms involved in reaction to injury or infection

A

Inflammation

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18
Q

Cytokines with antiviral properties; also active against certain tumors & inflammatory processes

A

Interferons

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19
Q

Cytokines produced by leukocytes that affect inflammatory response through increase in soluble factors or cells

A

Interleukins

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20
Q

Molecule that binds to another molecule of complementary configuration; the substance being measured in an immunoassay

A

Ligand

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21
Q

Enzyme found in tears & saliva that attacks cell walls of microorganisms

A

Lysozyme

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22
Q

System of genes that control expression of MHC molecules found on all nucleated cells; originally referred to as human leukocyte antigens (HLA)

A

Major histocompatibility complex (MHC)

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23
Q

Antibody derived from single B-cell clone, frequently used in clinical laboratory assays such as enzyme-linked immunosorbent assay (ELISA)

A

Monoclonal antibody

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24
Q

Serum proteins that attach to a foreign substance & enhance phagocytosis; most often complement or antibody

A

Opsonin

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25
Q

Step-wise engulfment of cells or particulate matter by neutrophils & macrophages

A

Phagocytosis

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26
Q

Transformed B cells that secret antibody

A

Plasma cells

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27
Q

Antibody produced by many B-cell clones

A

Polyclonal antibody

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28
Q

Reduced ag/ab complexes due to antigen excess; can cause false negative in serological test for antibodies; repeat test in 1-2 weeks

A

Postzone

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29
Q

Reduced ag/ab complexes due to antibody excess; can cause false negative in serological tests for antibodies; dilute serum & retest

A

Prozone

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30
Q

Change of serological test from negative to positive due to development of detectable antibodies

A

Seroconversion

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31
Q

Small, flat bilobed organ found in thorax; site of T-lymphocyte development; one of two primary lymphoid organs (bone marrow is the other primary lymphoid organ)

A

Thymus

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32
Q

Means of expressing antibody concentration; reciprocal of highest dilution with positive reaction

A

Titer

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33
Q

Injection of immunogenic material to induce immunity

A

Vaccination

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34
Q

When the number of multivalent sites of antigen & antibody are approximately equal; results in optimal reactions

A

Zone of equivalence

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35
Q

Branches of the immune system - Cellular - definition

A

cell-mediated

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36
Q

Branches of the immune system - Cellular - defense against

A

-viruses
-fungi
-mycobacteria
-other intracellular pathogens
-tumor cells

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37
Q

Branches of the immune system - Cellular - cells involved

A

-T-cells
-macrophages

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38
Q

Branches of the immune system - Cellular - examples

A

-graft rejection
-hypersensitivity reactions
-elimination of tumor cells

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39
Q

Branches of the immune system - Humoral - definition

A

antibody mediated

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40
Q

Branches of the immune system - Humoral - defense against

A

bacteria (extracellular)

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41
Q

Branches of the immune system - Humoral - cells involved

A

-B cells
-plasma cells

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42
Q

Branches of the immune system - Humoral - examples

A

antibody production

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43
Q

Types of immunity - innate - explanation

A

defense mechanisms present at birth; not antigen specific

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44
Q

Types of immunity - innate - components

A

External defense system:
-intact skin
-mucous membranes
-cilia & mucus in RT
-stomach acid
-flushing of urine
-lactic acid in vagina
-lysozyme in tears & saliva
-normal flora

Internal defense system:
-neutrophils
-macrophages
-acute phase reactants
-complement
-chemokines

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45
Q

Types of immunity - innate - memory?

A

NO

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46
Q

Types of immunity - acquired or adaptive - explanation

A

defense mechanisms that are antigen specific

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47
Q

Types of immunity - acquired or adaptive - components

A

-T-cells
-B-cells
-plasma cells
-antibodies
-cytokines

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48
Q

Types of immunity - acquired or adaptive - memory?

A

YES

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49
Q

Adaptive immunity - naturally acquired active immunity - explanation

A

individual infected with microorganism produces antibodies

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50
Q

Adaptive immunity - naturally acquired active immunity - example

A

clinical or subclinical infection

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51
Q

Adaptive immunity - naturally acquired active immunity - specific?

A

yes

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52
Q

Adaptive immunity - naturally acquired active immunity - immediate?

A

no

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53
Q

Adaptive immunity - naturally acquired active immunity - long-term?

A

yes

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54
Q

Adaptive immunity - artificially acquired active immunity - explanation

A

individual exposed to antigen through vaccine develops immunity without having the infection

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55
Q

Adaptive immunity - artificially acquired active immunity - explanation

A

individual exposed to antigen through vaccine develops immunity without having the infection

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56
Q

Adaptive immunity - artificially acquired active immunity - example

A

-Diphtheria, tetanus, pertussis vaccine (DTap)
-measles, mumps, rubella vaccine (MMR)
-polio vaccine
-tetanus vaccine
-Haemophilus influenzae type b (Hib) vaccine

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57
Q

Adaptive immunity - artificially acquired active immunity - specific?

A

yes

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58
Q

Adaptive immunity - artificially acquired active immunity - immediate?

A

no

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59
Q

Adaptive immunity - artificially acquired active immunity - long-term?

A

yes

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60
Q

Adaptive immunity - naturally acquired passive immunity - explanation

A

individual protected by antibodies produced by another person

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61
Q

Adaptive immunity - naturally acquired passive immunity - example

A

maternal antibodies that cross the placenta and are present in breast milk

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62
Q

Adaptive immunity - naturally acquired passive immunity - specific?

A

yes

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63
Q

Adaptive immunity - naturally acquired passive immunity - immediate?

A

yes

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64
Q

Adaptive immunity - naturally acquired passive immunity - long-term?

A

no

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65
Q

Adaptive immunity - artificially acquired passive immunity - explanation

A

individual receives immune globulin containing antibodies produced by another person

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66
Q

Adaptive immunity - artificially acquired passive immunity - example

A

-Rh immune globulin
-convalescent plasma
-antitoxins

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67
Q

Adaptive immunity - artificially acquired passive immunity - specific?

A

yes

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68
Q

Adaptive immunity - artificially acquired passive immunity - immediate?

A

yes

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69
Q

Adaptive immunity - artificially acquired passive immunity - long-term?

A

no

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70
Q

Cells of the innate immune system - granulocytes - neutrophils - function

A

-phagocytosis
-inflammatory response

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71
Q

Cells of the innate immune system - granulocytes - neutrophils - respond to?

A

Chemotaxins

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72
Q

Cells of the innate immune system - granulocytes - neutrophils - granules contain?

A

Bactericidal enzymes

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73
Q

Cells of the innate immune system - granulocytes - eosinophils - function

A

-neutralization of basophil & mast cell products
-destruction of some helminths
-hypersensitivity reactions

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74
Q

Cells of the innate immune system - granulocytes - eosinophils - phagocytic ability?

A

Some

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75
Q

Cells of the innate immune system - granulocytes - basophils - function

A

Hypersensitivity reactions

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76
Q

Cells of the innate immune system - granulocytes - basophils - granules contain?

A

Histamine, heparin, eosinophil chemotactic factor A

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77
Q

Cells of the innate immune system - granulocytes - basophils - bind to what in an allergic reaction?

A

IgE

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78
Q

Cells of the innate immune system - granulocytes - basophils - when do granules release contents?

A

In presence of antigen

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79
Q

Cells of the innate immune system - mononuclears - monocytes - function

A

Phagocytosis

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80
Q

Cells of the innate immune system - Tissue cells - mast cells - function

A

Hypersensitivity reactions

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81
Q

Cells of the innate immune system - Tissue cells - mast cells - what type of cells?

A

Connective tissue cells

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82
Q

Cells of the innate immune system - Tissue cells - mast cells - similar to basophils

A

Yes, but they are larger and have more granules

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83
Q

Cells of the innate immune system - Tissue cells - mast cells - what do they bind to?

A

IgE

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84
Q

Cells of the innate immune system - mononuclears - monocytes - migration

A

Migrate to the tissues and become macrophages

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85
Q

Cells of the innate immune system - Tissue cells - mast cells - respond to?

A

Chemotaxins

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86
Q

Cells of the innate immune system - Tissue cells - macrophages - function

A

-phagocytosis
-elimination of bacteria, intracellular parasites, & tumor cells
-secretion of cell mediators
-antigen presentation

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87
Q

Cells of the innate immune system - Tissue cells - macrophages - activated by?

A

Contact with microorganisms or cytokines from T cells

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88
Q

Cells of the innate immune system - Tissue cells - dendritic cells - function

A

-phagocytosis
-presentation of antigens to T cells

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89
Q

Cells of the innate immune system - Tissue cells - dendritic cells - initiate?

A

Adaptive immune response

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90
Q

Cells of the innate immune system - Lymphocytes - Natural Killer (NK) cells - function

A

1st line of defense against tumor cells & cells infected with viruses

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91
Q

Cells of the innate immune system - Lymphocytes - Natural Killer (NK) cells - lymphocytes without?

A

T or B markers

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92
Q

Cells of the innate immune system - Lymphocytes - Natural Killer (NK) cells - surface antigens?

A

no unique surface antigens, but CD16+ and CD56+

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93
Q

Cells of the innate immune system - Lymphocytes - Natural Killer (NK) cells - bridge between?

A

innate and acquired immunity

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94
Q

Cells of the innate immune system - Lymphocytes - Natural Killer (NK) cells - specificity?

A

no

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95
Q

Cells of the innate immune system - Lymphocytes - Natural Killer (NK) cells - stimulated by?

A

cytokines

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96
Q

Cells of the innate immune system - Lymphocytes - Natural Killer (NK) cells - released?

A

early infection - provides time for T & B cells to be activated

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97
Q

Cells of the innate immune system - Lymphocytes - Natural Killer (NK) cells - % of lymphs?

A

<20%

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98
Q

Cells of the innate immune system - Lymphocytes - Natural Killer (NK) cells - key cell in what?

A

antibody-dependent cellular cytotoxicity (ADCC)

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99
Q

Cells of the acquired immune system - T-lymphocytes (T cells) - function

A

cell-mediated immunity

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100
Q

Cells of the acquired immune system - T-lymphocytes (T cells) - derived from?

A

cells in bone marrow

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101
Q

Cells of the acquired immune system - T-lymphocytes (T cells) - where do they develop T-cell-specific surface antigens?

A

thymus

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102
Q

Cells of the acquired immune system - T-lymphocytes (T cells) - % of lymphs?

A

60-80%

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103
Q

Cells of the acquired immune system - Helper T cells - function

A

-orchestrate cell-mediated immunity
-activate B cells, cytotoxic cells, & NK cells

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104
Q

Cells of the acquired immune system - Helper T cells - surface antigen

A

CD4+

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105
Q

Cells of the acquired immune system - Helper T cells - constitutes how much of peripheral T cells?

A

2/3

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106
Q

Cells of the acquired immune system - Helper T cells - normal CD4 concentration

A

1,000/uL

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107
Q

Cells of the acquired immune system - Helper T cells - CD4 concentration in AIDS

A

<200/uL

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108
Q

Cells of the acquired immune system - Cytotoxic T cells - function

A

-suppressor cells inhibit helper T cells
-cytotoxic cells kill other cells

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109
Q

Cells of the acquired immune system - Cytotoxic T cells - surface antigen

A

CD8+

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110
Q

Cells of the acquired immune system - Cytotoxic T cells - constitutes how much of peripheral T cells?

A

1/3

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111
Q

Cells of the acquired immune system - Cytotoxic T cells - normal CD4/CD8 ratio?

A

2:1

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112
Q

Cells of the acquired immune system - Cytotoxic T cells - CD4/CD8 ratio in AIDS?

A

<0.5:1

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113
Q

Cells of the acquired immune system - T regulatory cells - function

A

suppress immune response to self

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114
Q

Cells of the acquired immune system - T regulatory cells - surface antigens

A

CD4+ and CD25+

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115
Q

Cells of the acquired immune system - B lymphocytes (B cells) - function

A

after antigenic challenge, transform into blasts that give rise to plasma cells & memory cells

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116
Q

Cells of the acquired immune system - B lymphocytes (B cells) - develop where?

A

bone marrow

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117
Q

Cells of the acquired immune system - B lymphocytes (B cells) - mature cells have what on their surface?

A

immunoglobulins (IgM, IgD) that act as receptors for antigens

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118
Q

Cells of the acquired immune system - B lymphocytes (B cells) - constitute what percentage of lymphs in peripheral blood?

A

10-20%

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119
Q

Cells of the acquired immune system - plasma cells - function

A

antibody production

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120
Q

Cells of the acquired immune system - plasma cells - where are they located?

A

in peripheral lymphoid organs

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121
Q

Cells of the acquired immune system - plasma cells - do they divide?

A

no

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122
Q

Cells of the acquired immune system - memory cells - function

A

respond to antigens when encountered again with increased speed & intensity

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123
Q

Cells of the acquired immune system - memory cells - located?

A

in peripheral organs

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124
Q

Cells of the acquired immune system - memory cells - live span?

A

months to years

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125
Q

Cells of the acquired immune system - memory cells - what type of cells?

A

can be B or T cells

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126
Q

List the primary lymphoid organs.

A

-bone marrow
-thymus

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127
Q

List the secondary lymphoid organs.

A

-spleen
-lymph nodes
-tonsils
-appendix
-cutaneous-associated lymphoid tissue
-mucosal-associated lymphoid tissue (MALT), including Peyer patches in the lower ileum

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128
Q

Isolation & identification of lymphocytes - isolation

A

-density gradient centrifugation with separation media (e.g., Ficoll-Hypaque)
-layers from top to bottom:
–plasma
–mononuclear cells
–separation media
–RBCs
–granulocytes

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129
Q

Isolation & identification of lymphocytes - identification

A

-flow cytometry
-fluorescent-labeled monoclonal antibodies against specific surface antigens
-each antibody has different fluorescent tag
-light scattering measured as cells flow through laser beam
-common T-cell antigens tested: CD2, CD3, CD4, CD7, CD8
-common B-cell antigens tested: CD19, CD20, CD22, surface Ig

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130
Q

Immunoglobulin (Ig) structure - basic structure

A

2 heavy (H) chains + 2 light (L) chains held together by disulfide (S-S) bonds

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131
Q

Immunoglobulin (Ig) structure - heavy (H) chains

A

-determine Ig class (IgG, IgA, IgM, IgD, IgE)
-gamma, alpha, delta, mu, epsilon

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132
Q

Immunoglobulin (Ig) structure - light (L) chains

A

-kappa or lambda
-both found in all classes of Igs, but only 1 type per molecule
-free L chains = Bence Jones proteins

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133
Q

Immunoglobulin (Ig) structure - Fab fragment

A

-fragment antigen binding
-consists of 1 L chain & 1/2 H chain held together by S-S bonds
-2 per Ig
-each can bind antigen

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134
Q

Immunoglobulin (Ig) structure - Fc fragment

A

-fragment crystallizable
-carboxy-terminal halves of 2 H chains held together by S-S bonds
-site of antibody biological activity such as opsonization & complement fixation

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135
Q

Immunoglobulin (Ig) structure - Constant region

A

carboxy-terminal ends of H & L chains where amino acid sequence is same for all chains of that type

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136
Q

Immunoglobulin (Ig) structure - variable region

A

-amino-terminal ends of H & L chains where amino acid sequence varies
-also known as antigen-recognition unit
-responsible for Ig specificity

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137
Q

Immunoglobulin (Ig) structure - Hinge region

A

-flexible portion of H chain between 1st & 2nd constant regions
-allows molecule to bend so that 2 antigen-binding sites can operate independently

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138
Q

Immunoglobulin (Ig) structure - Joining chain

A

glycoprotein that links Ig monomers in IgM & secretory IgA

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139
Q

Immunoglobulins - IgG - form in serum

A

monomer

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140
Q

Immunoglobulins - IgG - molecular weight (daltons)

A

150,000

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141
Q

Immunoglobulins - IgG - H chain

A

gamma

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142
Q

Immunoglobulins - IgG - L chain

A

Kappa or lambda

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143
Q

Immunoglobulins - IgG - % of total Ig

A

70-75%

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144
Q

Immunoglobulins - IgG - % of total Ig

A

70-75%

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145
Q

Immunoglobulins - IgG - serum concentration (mg/dL)

A

800-1,600 mg/dL

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146
Q

Immunoglobulins - IgG - antigen binding sites

A

2

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147
Q

Immunoglobulins - IgG - complement fixation

A

yes

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148
Q

Immunoglobulins - IgM - form in serum

A

pentamer

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149
Q

Immunoglobulins - IgM - molecular weight (daltons)

A

900,000

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150
Q

Immunoglobulins - IgM - H chain

A

Mu

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151
Q

Immunoglobulins - IgM - L chain

A

kappa or lambda

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152
Q

Immunoglobulins - IgM - % of total Ig

A

10%

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153
Q

Immunoglobulins - IgM - serum concentration (mg/dL)

A

120-150 mg/dL

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154
Q

Immunoglobulins - IgM - antigen binding sites

A

10

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155
Q

Immunoglobulins - IgM - complement fixation

A

yes

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156
Q

Immunoglobulins - IgA - form in serum

A

monomer & dimer

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157
Q

Immunoglobulins - IgA - molecular weight (daltons)

A

160,000 or 400,000

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158
Q

Immunoglobulins - IgA - H chain

A

alpha

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159
Q

Immunoglobulins - IgA - L chain

A

kappa or lambda

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160
Q

Immunoglobulins - IgA - % of total Ig

A

10-15%

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161
Q

Immunoglobulins - IgA - serum concentration (mg/dL)

A

70-350 mg/dL

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162
Q

Immunoglobulins - IgA - antigen binding sites

A

2 or 4

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163
Q

Immunoglobulins - IgA - antigen binding sites

A

2 or 4

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164
Q

Immunoglobulins - IgA - complement fixation

A

no

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165
Q

Immunoglobulins - IgD - form in serum

A

monomer

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166
Q

Immunoglobulins - IgD - molecular weight (daltons)

A

180,000

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167
Q

Immunoglobulins - IgD - H chain

A

delta

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168
Q

Immunoglobulins - IgD - L chain

A

kappa or lambda

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169
Q

Immunoglobulins - IgD - % of total Ig

A

<1%

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170
Q

Immunoglobulins - IgD - serum concentration (mg/dL)

A

1-3 mg/dL

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171
Q

Immunoglobulins - IgD - antigen binding sites

A

2

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172
Q

Immunoglobulins - IgD - complement fixation

A

no

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173
Q

Immunoglobulins - IgE - form in serum

A

monomer

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174
Q

Immunoglobulins - IgE - molecular weight (daltons)

A

190,000

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175
Q

Immunoglobulins - IgE - H chain

A

epsilon

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176
Q

Immunoglobulins - IgE - L chain

A

kappa or lambda

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177
Q

Immunoglobulins - IgE - % of total Ig

A

0.002%

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178
Q

Immunoglobulins - IgE - serum concentration (mg/dL)

A

0.005 mg/dL

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179
Q

Immunoglobulins - IgE - antigen binding sites

A

2

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180
Q

Immunoglobulins - IgE - complement fixation

A

no

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181
Q

Immunoglobulins - IgG - crosses placenta?

A

Yes

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182
Q

Immunoglobulins - IgG - role(s)

A

-defense against bacteria & viruses
-neutralizes toxins
-opsonin
-passive immunity in newborns

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183
Q

Immunoglobulins - IgG - precipitation/agglutination

A

more efficient at precipitation than agglutination

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184
Q

Which immunoglobulin is the main Ig produced during memory (recall) response to antigens?

A

IgG

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185
Q

Immunoglobulins - IgM - crosses placenta?

A

no

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186
Q

Immunoglobulins - IgM - role(s)

A

-neutralizes toxins
-opsonin

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187
Q

Immunoglobulins - IgM - more efficient at what than IgG?

A

agglutination

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188
Q

Immunoglobulins - IgM - destroyed by?

A

sulfhydryl compounds

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189
Q

Which immunoglobulin is the first Ig produced in the immune response?

A

IgM

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190
Q

Which immunoglobulin is the only Ig produced by newborns?

A

IgM

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191
Q

Which immunoglobulin is the only Ig produced by newborns?

A

IgM

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192
Q

Which immunoglobulin is the most efficient Ig at initiating the complement cascade?

A

IgM

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193
Q

Immunoglobulins - IgA - crosses placenta?

A

no

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194
Q

Immunoglobulins - IgA - role(s)

A

-1st line of defense
-patrols mucosal surfaces
-prevents adherence of bacteria and neutralizes toxins

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195
Q

Immunoglobulins - IgA - located?

A

-tears
-sweat
-respiratory mucosa
-GI mucosa
-breast milk

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196
Q

Immunoglobulins - IgD - crosses placenta?

A

no

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197
Q

Immunoglobulins - IgD - role(s)

A

may play a role in B-cell maturation

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198
Q

Immunoglobulins - IgD - on surface of what cells?

A

B cells

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199
Q

Immunoglobulins - IgE - crosses placenta?

A

no

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200
Q

Immunoglobulins - IgE - role(s)

A

-role in allergic reactions
-binds to basophils & mast cells
-when 2 adjacent molecules on mast cells bind antigens, degranulation of cell with release of histamine & heparin

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201
Q

Immunoglobulins - IgE - type of hypersensitivity reaction

A

Type I immediate hypersensitivity reaction

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202
Q

Complement - definition

A

-group of >30 proteins involved in phagocytosis & clearance of foreign antigen
-most are inactive enzyme precursors that are converted to active enzymes in precise order (cascade)

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203
Q

Complement - functions

A

-inflammation
-opsonization
-chemotaxis
-cell lysis

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204
Q

Complement - classical pathway

A

-triggered by ag/ab reaction
-IgM is most efficient activator
-single molecule attached to 2 adjacent antigens can initiate cascade
-IgG1, 2, & 3 can activate complement but at least 2 molecules required

-recognition unit: C1 (first to bind)
-activation unit: C4, C2, C3
-membrane attack complex: C5, C6, C7, C8, C9 (cell lysis)

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205
Q

Complement - alternative pathway

A

-antibody dependent
-activated by bacteria, fungi, viruses, tumor cells, some parasites

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206
Q

Complement - lectin pathway

A

-antibody independent
-initiated by mannose-binding lectin (MBL)
-nonspecific recognition of sugars on microorganisms
-important defense mechanism in infancy

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207
Q

Complement - present in highest concentration in plasma

A

C3 (key component of all 3 pathways)

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208
Q

Complement - deficiencies

A

-increased susceptibility to infection
-accumulation of immune complexes, which can lead to glomerulonephritis

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209
Q

Complement - ions required

A

calcium and magnesium

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210
Q

Complement - inactivation

A

56*C for 30 minutes

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211
Q

Hypersensitivity reactions - Type I: Anaphylactic - key reactant(s)

A

IgE

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212
Q

Hypersensitivity reactions - Type I: Anaphylactic - mechanism

A

release of mediators from eosinophils, mast cells, & basophils

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213
Q

Hypersensitivity reactions - Type I: Anaphylactic - onset of symptoms

A

immediate

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214
Q

Hypersensitivity reactions - anaphylaxis - type of hypersensitivity reaction?

A

Type I: Anaphylactic

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215
Q

Hypersensitivity reactions - hay fever - type of hypersensitivity reaction?

A

Type I: Anaphylactic

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216
Q

Hypersensitivity reactions - asthma - type of hypersensitivity reaction?

A

Type I: Anaphylactic

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217
Q

Hypersensitivity reactions - food allergies - type of hypersensitivity reaction?

A

Type I: Anaphylactic

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218
Q

Hypersensitivity reactions - transfusion reactions - type of hypersensitivity reaction?

A

Type II: Cytotoxic

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219
Q

Hypersensitivity reactions - HDN - type of hypersensitivity reaction?

A

Type II: Cytotoxic

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220
Q

Hypersensitivity reactions - autoimmune hemolytic anemia - type of hypersensitivity reaction?

A

Type II: Cytotoxic

221
Q

Hypersensitivity reactions - Arthus reaction - type of hypersensitivity reaction?

A

Type III: Immune complex

222
Q

Hypersensitivity reactions - serum sickness - type of hypersensitivity reaction?

A

Type III: Immune complex

223
Q

Hypersensitivity reactions - SLE - type of hypersensitivity reaction?

A

Type III: Immune complex

224
Q

Hypersensitivity reactions - rheumatoid arthritis (RA) - type of hypersensitivity reaction?

A

Type III: Immune complex

225
Q

Hypersensitivity reactions - contact dermatitis - type of hypersensitivity reaction?

A

Type IV: Cell dependent

226
Q

Hypersensitivity reactions - hypersensitivity pneumonitis - type of hypersensitivity reaction?

A

Type IV: Cell dependent

227
Q

Hypersensitivity reactions - tuberculin skin test - type of hypersensitivity reaction?

A

Type IV: Cell dependent

228
Q

Hypersensitivity reactions - Type II: Cytotoxic - key reactant(s)

A

IgG, IgM, complement, cellular antigens

229
Q

Hypersensitivity reactions - Type II: Cytotoxic - mechanism

A

cytolysis due to antibody & complement

230
Q

Hypersensitivity reactions - Type II: Cytotoxic - onset of symptoms

231
Q

Hypersensitivity reactions - Type II: Immune Complex - key reactant(s)

A

IgG, IgM, complement, soluble antigen

232
Q

Hypersensitivity reactions - Type III: Immune Complex - key reactant(s)

A

IgG, IgM, complement, soluble antigen

233
Q

Hypersensitivity reactions - Type III: Immune Complex - mechanism

A

deposits of antigen-antibody complexes in tissues

234
Q

Hypersensitivity reactions - Type III: Immune Complex - onset of symptoms

235
Q

Hypersensitivity reactions - Type IV: T-Cell Dependent - key reactant(s)

A

T cells, antigen-presenting cells (APCs)

236
Q

Hypersensitivity reactions - Type IV: T-Cell Dependent - mechanism

A

release of cytokines

237
Q

Hypersensitivity reactions - Type IV: T-Cell Dependent - onset of symptoms

A

delayed - sensitization after 1st contact with antigen, symptoms upon reexposure

238
Q

Agglutination methods - direct agglutination - principle

A

-naturally occurring antigens on particles (e.g., bacterial antigens)
-particles agglutinate in the presence of corresponding antibody

239
Q

Agglutination methods - direct agglutination - application

A

-Widal test for typhoid fever
-Salmonella O & H antigens used to detect antibodies in patient serum
-test used in developing countries

240
Q

Agglutination methods - hemagglutination - principle

A

antigen-antibody reactions that results in clumping of RBCs

241
Q

Agglutination methods - hemagglutination - application

A

ABO typing

242
Q

Agglutination methods - passive (indirect) agglutination - principle

A

-soluble antigens bound to particles, e.g., latex
-particles agglutinate in presence of corresponding antibody

243
Q

Agglutination methods - passive (indirect) agglutination - application

A

antibody to Group A Streptococcus (GAS) or antibody to rotavirus or cytomegalovirus (CMV)

244
Q

Agglutination methods - reverse passive agglutination - principle

A

-antibody attached to carrier particles
-particles agglutinate in presence of corresponding antigen

245
Q

Agglutination methods - reverse passive agglutination - application

A

-kits available for rapid ID of bacteria such as Group B Streptococcus (GBS), Staphylococcus aureus, and Cryptococcus neoformans

246
Q

Agglutination methods - agglutination inhibition - principle

A

-competition between particulate antigen (reagent) & soluble antigen (in specimen) for sites on reagent antibody
-lack of agglutination is a positive results

247
Q

Agglutination methods - agglutination inhibition - application

A

-detection of illicit drugs
-controls are crucial to confirm lack of agglutination

248
Q

Agglutination methods - hemagglutination inhibition - principle

A

-detects antibodies to certain viruses that agglutinate RBCs
-in presence of antibody, virus is neutralized & hemagglutination doesn’t occur

249
Q

Agglutination methods - hemagglutination inhibition - application

A

-Rubella & other viruses
-controls are crucial to confirm lack of hemagglutination

250
Q

Precipitation methods - precipitation - principle

A

-soluble antigen combines with soluble antibody to produce visible complexes
-less sensitive than agglutination

251
Q

Precipitation methods - Ouchterlony double diffusion - principle

A

antigens & antibodies diffuse from wells in gel & form precipitin lines where they meet

252
Q

Precipitation methods - Ouchterlony double diffusion - application

A

fungal antigens

253
Q

Precipitation methods - Radial immunodiffusion (RID) - principle

A

-antigen diffuses out of well in gel containing antibody
-precipitin ring forms
-diameter proportionate to concentration of antigen

254
Q

Precipitation methods - Radial immunodiffusion (RID) - application

A

largely replaced by more sensitive methods such as nephelometry and enzyme-linked immunoassays

255
Q

Precipitation methods - Immunofixation electrophoresis (IFE) - principle

A

-proteins separated by electrophoresis
-antiserum places directly in gel
-antigen-antibody complexes precipitate

256
Q

Precipitation methods - Immunofixation electrophoresis (IFE) - application

A

-identification of Igs in monoclonal gammopathies
-Bence Jones proteins
-also useful for detection of antigen present in serum, urine, or CSF at low concentrations

257
Q

Precipitation methods - Nephelometry - principle

A

-light scattering by antigen-antibody complexes
-amount of light scattered is proportional to concentration

258
Q

Precipitation methods - Nephelometry - application

A

-Igs
-complement
-C-reactive protein (CRP)
-haptoglobin
-ceruloplasmin

259
Q

substance being measured in immunoassay; can be antigen or antibody

260
Q

immunoassay in which patient antigen & labeled reagent antigen compete for binding sites on reagent antibody

A

competitive

261
Q

immunoassay that doesn’t involve competition for binding sites; more sensitive than competitive assays

A

noncompetitive

262
Q

immunoassay with separation step to remove from bound analyte; more sensitive than homogeneous assays

A

heterogeneous

263
Q

immunoassay that doesn’t require separation step; easier to automate

A

homogeneous

264
Q

any immunoassay that uses an enzyme as a label; a substrate is added to measure enzyme activity

265
Q

1st type of EIA developed; competitive; enzyme-labeled reagent is part of initial ag-ab reaction; all reactants added at same time; 1 incubation & 1 wash

A

Direct EIA

266
Q

noncompetitive EIA; enzyme-labeled reagent isn’t involved in initial ag-ab reaction; 2 incubations & 2 washes; more sensitive than direct assays; also known as ELISA

A

Indirect EIA

267
Q

reagent ag or ab bound to support medium, e.g., polystyrene test tubes, microtiter plates, cellulose membranes, glass beads

A

solid phase

268
Q

EIA formats - EIA - description

A

heterogeneous, competitive, direct

269
Q

EIA formats - EIA - principle

A

-enzyme-labeled ligand & unlabeled patient ligand compete for binding sites on antibody attached to solid phase
-free labeled ligand removed by washing
-substrate added
-color inversely proportional to concentration of ligand in specimen

270
Q

EIA formats - EIA - used to measure?

A

small relatively pure antigens, e.g., insulin, estrogen

271
Q

EIA formats - ELISA - description

A

heterogeneous, noncompetitive, indirect

272
Q

EIA formats - ELISA - principle

A

-antigen attached to solid phase
-antibody in specimen attaches
-unbound antibody removed by washing
-enzyme-labeled antiglobulin added
-attaches to antibody on solid phase
-substrate added
-color directly proportional to antibody concentration
-more sensitive than competitive EIA
-one of the most common immunoassays

273
Q

EIA formats - ELISA - used to detect?

A

antibodies to viruses, e.g., HIV, hepatitis A (HAV), HCV, EBV

274
Q

EIA formats - Sandwich ELISA or capture assay - description

A

heterogeneous, noncompetitive, indirect

275
Q

EIA formats - Sandwich ELISA or capture assay - principle

A

-antibody attached to solid phase
-antigen in specimen attaches
-enzyme-labeled antibody added, attaches to different determinant
-enzymatic activity directly proportional to amount of antigen in sample

276
Q

EIA formats - Sandwich ELISA or capture assay - antigen must have?

A

multiple determinants

277
Q

EIA formats - Sandwich ELISA or capture assay - used to measure?

A

-hormones
-proteins
-detect tumor markers
-viruses
-parasites
-fungi

278
Q

EIA formats - Sandwich ELISA or capture assay - high concentration of antigen can cause?

A

Hook effect - too much antigen for binding sites so undiluted sample has lower absorbance than dilutions

279
Q

EIA formats - Rapid ELISA (lateral flow) - description

A

membrane based

280
Q

EIA formats - Rapid ELISA (lateral flow) - principle

A

-reagent antigen or antibody bound to membrane in single use cassette
-sample added
-presence of ag-ab complex indicated by colored reaction

281
Q

EIA formats - Rapid ELISA (lateral flow) - examples

A

pregnancy tests, cardiac troponin, SARS-CoV 2

-usually qualitative and designed primarily for POCT or at home testing

282
Q

EIA formats - Enzyme-multiplied immunoassay technique (EMIT) - description

A

homogeneous

283
Q

EIA formats - Enzyme-multiplied immunoassay technique (EMIT) - principle

A

-antigen in specimens & enzyme-labeled antigen compete for binding sites on reagent antibody
-when enzyme-labeled antigen binds, enzyme activity inhibited
-enzyme activity is directly proportional to concentration of antigen in specimen

284
Q

EIA formats - Enzyme-multiplied immunoassay technique (EMIT) - used for?

A

determination of low molecular weight analytes not readily measured by other methods, e.g., drugs and some hormones
-automated

285
Q

Fluorescent immunoassays (FIA) - direct fluorescent antibody (DFA) staining - principle

A

-specimen on glass slide overlaid with fluorescein-labeled antibody
-if corresponding antigen is present, labeled antibody binds
-fluorescence observed with fluorescent microscope

286
Q

Fluorescent immunoassays (FIA) - direct fluorescent antibody (DFA) staining - detects?

287
Q

Fluorescent immunoassays (FIA) - direct fluorescent antibody (DFA) staining - fluorescent labels

A

Fluorescein isothiocyanate or rhodamine B isothiocyanate

288
Q

Fluorescent immunoassays (FIA) - direct fluorescent antibody (DFA) staining - examples of analytes

A

bacteria, viral antigen

289
Q

Fluorescent immunoassays (FIA) - indirect fluorescent antibody (IFA) staining - principle

A

-reagent antigen on glass slide overlaid with patient serum
-if corresponding antibody is present in serum, attached to the antigen
-when fluorescein-labeled antihuman globulin is added, attaches to antibody
-fluorescence observed with fluorescent microscope

290
Q

Fluorescent immunoassays (FIA) - indirect fluorescent antibody (IFA) staining - detects?

A

antibodies in serum

“Sandwich technique”

291
Q

Fluorescent immunoassays (FIA) - indirect fluorescent antibody (IFA) staining - examples of analytes

A

-antinuclear antibody (ANA)
-fluorescent treponemal antibody (FTA)

292
Q

Fluorescent immunoassays (FIA) - fluorescence polarization immunoassay (FPIA) - principle

A

-labeled antigen competes with antigen in specimen for sites on reagent antibody
-free labeled antigen rotates rapidly, emits little polarized light
-bound labeled antigen rotates more slowly, emits more polarized light
-amount of polarized light is inversely proportional to concentration of antigen in specimen

293
Q

Fluorescent immunoassays (FIA) - fluorescence polarization immunoassay (FPIA):
-competitive or noncompetitive?
-heterogeneous or homogenerous?

A

-competitive
-homogeneous

294
Q

Fluorescent immunoassays (FIA) - fluorescence polarization immunoassay (FPIA) - examples of analytes

A

therapeutic drugs, hormones

295
Q

Comparison of labeled immunoassays - EIA - labels

A

-alkaline phosphatase
-horseradish peroxidase
-Alpha-D-galactosidase
-glucose-6-phosphate dehydrogenase

296
Q

Comparison of labeled immunoassays - EIA - detection

A

enzymes react with substrate to produce color change

297
Q

Comparison of labeled immunoassays - EIA - type(s) of assays available

A

-mostly noncompetitive now
-heterogenous or homogeneous

298
Q

Comparison of labeled immunoassays - EIA - advantages

A

-sensitivity
-specificity
-no health hazard or disposal problems
-reagents with long shelf life
-can be automated

299
Q

Comparison of labeled immunoassays - EIA - disadvantages

A

-natural inhibitors in some specimens
-cross reactivity of some substances

300
Q

Comparison of labeled immunoassays - EIA - use

301
Q

Comparison of labeled immunoassays - FIA - labels

A

-fluorescein
-rhodamine

302
Q

Comparison of labeled immunoassays - FIA - detection

A

fluorochromes absorb energy from light source, convert to longer wavelength (lower energy)

303
Q

Comparison of labeled immunoassays - FIA - type(s) of assays available

A

-usually competitive
-heterogeneous & homogeneous

304
Q

Comparison of labeled immunoassays - FIA - advantages

A

-sensitivity
-specificity
-no health hazard or disposal problems
-reagent with long shelf life
-automated

305
Q

Comparison of labeled immunoassays - FIA - disadvantages

A

-autofluorescence from organic substances in serum
-nonspecific binding to substances in serum
-expensive, dedicated instrumentation

306
Q

Comparison of labeled immunoassays - FIA - use

307
Q

Comparison of labeled immunoassays - Chemiluminescent Immunoassay (CIA) - labels

A

-luminol
-acridinium esters
-ruthenium derivatives
-nitrophenyl oxalates

308
Q

Comparison of labeled immunoassays - Chemiluminescent Immunoassay (CIA) - detection

A

chemiluminescent molecules produce light from chemical reaction

309
Q

Comparison of labeled immunoassays - Chemiluminescent Immunoassay (CIA) - type(s) of assays available

A

-competitive & noncompetitive
-heterogeneous & homogeneous

310
Q

Comparison of labeled immunoassays - Chemiluminescent Immunoassay (CIA) - advantages

A

-sensitivity
-specificity
-no health hazard or disposal problems
-reagent with long shelf life
-automated

311
Q

Comparison of labeled immunoassays - Chemiluminescent Immunoassay (CIA) - disadvantages

A

quenching of light emission by some biological materials

312
Q

Comparison of labeled immunoassays - Chemiluminescent Immunoassay (CIA) - use

313
Q

Nontreponemal tests for syphilis - VDRL - method

A

flocculation

314
Q

Nontreponemal tests for syphilis - VDRL - detects

A

reagin

(antibody against cardiolipin that is in serum of patients with syphilis)

315
Q

Nontreponemal tests for syphilis - VDRL - antigen

A

cardiolipin

316
Q

Nontreponemal tests for syphilis - VDRL - positive reaction

A

microscopic clumps

317
Q

Nontreponemal tests for syphilis - VDRL - specimen(s)

A

-inactivated serum
-CSF

318
Q

Nontreponemal tests for syphilis - VDRL - reactivity during disease

A

-Primary stage: may be negative
-Secondary or early late stages: titers usually peak
-more rapid decline with treatment
-becomes non-reactive in 1-2 years following successful treatment

319
Q

Nontreponemal tests for syphilis - VDRL - false positives

A

Biologic false positives:
–infectious mono (IM)
–infectious hepatitis
–malaria
–leprosy
–lupus erythematosus
–RA
–advanced age
–pregnancy

Reactive in other treponemal infections such as yaws & pinta.

320
Q

Nontreponemal tests for syphilis - VDRL - reactives should be confirmed by?

A

treponemal test

321
Q

Nontreponemal tests for syphilis - VDRL - replaced by?

A

RPR for serum

322
Q

Nontreponemal tests for syphilis - VDRL - CSF

A

diagnosis of neurosyphilis

323
Q

Nontreponemal tests for syphilis - RPR - method

A

flocculation

324
Q

Nontreponemal tests for syphilis - RPR - detects

325
Q

Nontreponemal tests for syphilis - RPR - antigen

A

cardiolipin with charcoal

326
Q

Nontreponemal tests for syphilis - RPR - positive reaction

A

macroscopic agglutination

327
Q

Nontreponemal tests for syphilis - RPR - specimen(s)

A

-serum (inactivation not required)
-plasma

328
Q

Nontreponemal tests for syphilis - RPR - reactivity during disease

A

-Primary stage: may be negative
-Secondary or early late stages: titers usually peak
-more rapid decline with treatment
-becomes non-reactive in 1-2 years following successful treatment

329
Q

Nontreponemal tests for syphilis - RPR - reactives should be confirmed by?

A

treponemal test

330
Q

Treponemal tests for syphilis - Fluorescent treponemal antibody absorption (FTA-ABS) - detects

A

antibody to T. pallidum

331
Q

Treponemal tests for syphilis - Fluorescent treponemal antibody absorption (FTA-ABS) - reagent(s)

A

-sorbent (nonpathologic treponemes - Reiter strain)
-slides with Nichols strain of T. pallidum
-fluorescein-labeled antihuman globulin

332
Q

Treponemal tests for syphilis - Fluorescent treponemal antibody absorption (FTA-ABS) - positive reaction

A

fluorescence

333
Q

Treponemal tests for syphilis - Fluorescent treponemal antibody absorption (FTA-ABS) - specimen(s)

A

-serum
-CSF

334
Q

Treponemal tests for syphilis - Fluorescent treponemal antibody absorption (FTA-ABS) - reactivity during disease

A

-usually positive before non-treponemal tests
-some false negatives in primary syphilis
-usually positive for life

335
Q

Treponemal tests for syphilis - Treponema pallidum particle agglutination (TP-PA) - detects

A

antibody to T. pallidum

336
Q

Treponemal tests for syphilis - Treponema pallidum particle agglutination (TP-PA) - reagent(s)

A

colored gelatin particles coated with treponemal antigen

337
Q

Treponemal tests for syphilis - Treponema pallidum particle agglutination (TP-PA) - positive reaction

A

-agglutination of sensitized gel particles
-smooth mat over surface of well

338
Q

Treponemal tests for syphilis - Treponema pallidum particle agglutination (TP-PA) - specimen(s)

339
Q

Treponemal tests for syphilis - Treponema pallidum particle agglutination (TP-PA) - reactivity during disease

A

-not as sensitive in primary syphilis as FTA
-sensitivity close to 100% in secondary syphilis
-usually positive in late stages

340
Q

Treponemal tests for syphilis - Antibody capture enzyme-linked immunosorbent assay (ELISA) - detects

A

antibody to T. pallidum

341
Q

Treponemal tests for syphilis - Antibody capture enzyme-linked immunosorbent assay (ELISA) - reagent(s)

A

enzyme-labeled treponemal antigen

342
Q

Treponemal tests for syphilis - Antibody capture enzyme-linked immunosorbent assay (ELISA) - positive reaction

A

color development following addition of substrate

343
Q

Treponemal tests for syphilis - Antibody capture enzyme-linked immunosorbent assay (ELISA) - specimen(s)

344
Q

Treponemal tests for syphilis - Antibody capture enzyme-linked immunosorbent assay (ELISA) - reactivity during disease

A

high sensitivity

345
Q

Treponemal tests for syphilis - Antibody capture enzyme-linked immunosorbent assay (ELISA) - false positives

A

-fewer than nontreponemal tests
-reactive with other treponemal diseases (e.g., yaws, pinta)

346
Q

Treponemal tests for syphilis - Antibody capture enzyme-linked immunosorbent assay (ELISA) - used for?

A

screening & confirmation of reactive nontreponemal tests

347
Q

Treponemal tests for syphilis - Antibody capture enzyme-linked immunosorbent assay (ELISA) - used for screening

A

reactives should be confirmed with nontreponemal test (reverse sequence screening), followed by TP-PA or FTA-ABS if nontreponemal test is nonreactive

348
Q

Treponemal tests for syphilis - Antibody capture enzyme-linked immunosorbent assay (ELISA) - Dx of congenital syphilis

A

IgM capture assay

349
Q

Treponemal tests for syphilis - Fluorescent treponemal antibody absorption (FTA-ABS) - false positives

A

-fewer than nontreponemal tests
-reactive with other treponemal diseases, e.g., yaws, pinta

350
Q

Treponemal tests for syphilis - Fluorescent treponemal antibody absorption (FTA-ABS) - what does absorbent remove?

A

non-specific antibodies

351
Q

Treponemal tests for syphilis - Fluorescent treponemal antibody absorption (FTA-ABS) - used to confirm?

A

reactive nontreponemal tests

352
Q

Treponemal tests for syphilis - Fluorescent treponemal antibody absorption (FTA-ABS) - not good for?

A

treatment monitoring

353
Q

Treponemal tests for syphilis - Treponema pallidum particle agglutination (TP-PA) - false positives

A

fewer than nontreponemal tests

354
Q

Treponemal tests for syphilis - Treponema pallidum particle agglutination (TP-PA) - used to confirm?

A

reactive nontreponemal tests

355
Q

Treponemal tests for syphilis - Treponema pallidum particle agglutination (TP-PA) - positive result

A

a smooth mat will form in the base of the well of a microtitre plate, indicating a positive result

356
Q

Treponemal tests for syphilis - Treponema pallidum particle agglutination (TP-PA) - not good for?

A

treatment monitoring

357
Q

Interpretation of syphilis test results:
RPR: reactive
FTA: reactive

A

Positive for syphilis

358
Q

Interpretation of syphilis test results:
RPR: reactive
FTA: non-reactive

A

Negative for syphilis

359
Q

Interpretation of syphilis test results:
ELISA: reactive
RPR: reactive

A

Positive for syphilis

360
Q

Interpretation of syphilis test results:
ELISA: reactive
RPR: non-reactive
FTA-ABS: reactive

A

late, latent, or previous syphilis

361
Q

Serological tests for other bacterial infections - Anti-streptolysin O (ASO) - diagnosis

A

Sequelae of GAS infection: rheumatic fever, poststreptococcal glomerulonephritis

362
Q

Serological tests for other bacterial infections - Anti-streptolysin O (ASO) - common method(s)

A

nephelometry

363
Q

Serological tests for other bacterial infections - Anti-streptolysin O (ASO) - antigen used?

A

recombinant streptolysin antigen

364
Q

Serological tests for other bacterial infections - Anti-streptolysin O (ASO) - positive result

A

if antibody present, antigen-antibody complexes form, & increased light scatter

365
Q

Serological tests for other bacterial infections - Anti-DNase B - diagnosis

A

Sequelae of GAS infections: rheumatic fever, glomerulonephritis following skin infection, i.e., impetigo

366
Q

Serological tests for other bacterial infections - Anti-DNase B - common method(s)

A

EIA, nephelometry

367
Q

Serological tests for other bacterial infections - Anti-DNase B - advantages

A

-highly specific
-may be positive when ASO is negative

368
Q

Serological tests for other bacterial infections - Streptozyme - diagnosis

A

Sequelae of GAS infection

369
Q

Serological tests for other bacterial infections - Streptozyme - common method(s)

A

slide agglutination

370
Q

Serological tests for other bacterial infections - Streptozyme - principle

A

uses sheep RBCs coated with several streptococcal antigens

371
Q

Serological tests for other bacterial infections - Streptozyme - disadvantages

A

-more false positives & false negatives

Should be used in conjunction with ASO & anti-DNase
-serial titers should be performed

372
Q

Serological tests for other bacterial infections - Helicobacter pylori antibody - diagnosis

A

gastric & duodenal ulcers caused by H. pylori

373
Q

Serological tests for other bacterial infections - Helicobacter pylori antibody - common method(s)

A

-method of choice: ELISA
-rapid tests, PCR available

374
Q

Serological tests for other bacterial infections - Helicobacter pylori antibody - detect what Ig?

375
Q

Serological tests for other bacterial infections - Helicobacter pylori antibody - successful treatment

A

25% decrease in titer

376
Q

Serological tests for other bacterial infections - Helicobacter pylori antibody - antibody lifespan

377
Q

Serological tests for other bacterial infections - Helicobacter pylori antibody - positive rapid tests should be confirmed by?

378
Q

Serological tests for other bacterial infections - Mycoplasma pneumoniae antibody - diagnosis

A

primary atypical pneumonia (PAP)

379
Q

Serological tests for other bacterial infections - Mycoplasma pneumoniae antibody - common method(s)

A

-most common: EIA
-also agglutination, IFA
-molecular methods available

380
Q

Serological tests for other bacterial infections - Mycoplasma pneumoniae antibody - antibodies tested?

A

IgM & IgG antibodies

381
Q

Serological tests for other bacterial infections - Rickettsial antibody - diagnosis

A

-typhus
-rocky mountain spotted fever
-other rickettsial infections

382
Q

Serological tests for other bacterial infections - Rickettsial antibody - common method(s)

A

-Gold standard: IFA, micro-IFA
-PCR available

383
Q

Serological tests for infectious mononucleosis (IM) - heterophile antibodies - specificity

A

-non-specific antibodies that agglutinate horse, sheep, & bovine RBCs
-heterophile antibodies are antibodies that react with similar antigens from different species

384
Q

Serological tests for infectious mononucleosis (IM) - heterophile antibodies - occurrence

A

-90% of patients develop in 1st month of illness
-can persist for 1 year
-negative in 10% of adults & up to 50% of children with IM
-if symptomatic & heterophile negative, test for EBV-specific antibodies

385
Q

Serological tests for infectious mononucleosis (IM) - heterophile antibodies - tests

A

-rapid latex agglutination
-solid-phase immunoassay
-antigen is purified bovine RBC extract
-screening tests

386
Q

Serological tests for infectious mononucleosis (IM) - EBV-specific antibodies - specificity

A

-specific antibodies against EBV antigens present in different phases of infection:
–early: early antigen (EA)
–late: viral capsid antigen (VCA)
–latent: EBV nuclear antigen (EBNA)

387
Q

Serological tests for infectious mononucleosis (IM) - EBV-specific antibodies - occurrence

A

-anti-VCA IgM: appears at onset of symptoms, disappears in 3 months
-anti-VCA IgG: appears at onset of symptoms, persists for life
-anti-EBNA: present during convalescence

Acute infection:
-anti-VCA IgM,
-anti-VCA IgG
-anti-EA

Past infection:
-anti-EBNA
-anti-VCA IgG
-negative anti-VCA IgM

388
Q

Serological tests for infectious mononucleosis (IM) - EBV-specific antibodies - tests

A

-IFA - gold standard but time consuming & harder to interpret
-ELISA
-CIA
-molecular tests can be used for immunocompromised patients who don’t produce antibodies

389
Q

Hepatitis tests - Hepatitis A - Total anti-HAV - significance

A

past infection & immunity

390
Q

Hepatitis tests - Hepatitis A - IgM anti-HAV - significance

A

acute infection

391
Q

Hepatitis tests - Hepatitis A - HAV RNA - significance

A

current infection

392
Q

Hepatitis tests - Hepatitis A - HAV RNA - used to detect?

A

HAV in food and water

393
Q

Hepatitis tests - Hepatitis B - Hepatitis B surface antigen (HBsAg) - significance

A

acute or chronic infection, infectivity

394
Q

Hepatitis tests - Hepatitis B - Hepatitis B surface antigen (HBsAg) - confirmation of positive

A

repeat testing and another assay such as hepatitis B DNA PCR

395
Q

What is the first serological marker to appear during early acute infection of Hepatitis B?

A

Hepatitis B surface antigen (HBsAg)

396
Q

Hepatitis tests - Hepatitis B - Hepatitis B e antigen (HBeAg) - significance

A

acute or chronic infection

397
Q

Hepatitis tests - Hepatitis B - Hepatitis B e antigen (HBeAg) - indicative of?

A

high degree of infectivity

398
Q

Hepatitis tests - Hepatitis B - Total anti-Hepatitis B core (HBc) - significance

A

current or past infection or carrier

399
Q

Hepatitis tests - Hepatitis B - Total anti-Hepatitis B core (HBc) - prominent immunoglobulin

A

IgG, which persists for life

400
Q

Hepatitis tests - Hepatitis B - IgM anti-HBc - significance

A

current or recent infection

401
Q

Hepatitis tests - Hepatitis B - IgM anti-HBc - useful for detecting?

A

HBV infection when HBsAg is no longer detectable (“window period”)

402
Q

What is the first antibody to appear in hepatitis B?

A

IgM anti-HBc

403
Q

What tests are used to screen blood donors for hepatitis B?

A

HBsAG and IgM anti-HBc

404
Q

Hepatitis tests - Hepatitis B - Anti-HBe - significance

A

recovery, reduced infectivity

405
Q

Hepatitis tests - Hepatitis B - Anti-HBs - significance

A

recovery & immunity

406
Q

What antibody develops following immunization for hepatitis B?

407
Q

Hepatitis tests - Hepatitis B - Hepatitis B virus (HBV) DNA - significance

A

current infection

408
Q

What is detectable 21 days before HBsAg in hepatitis B?

A

Hepatitis B virus (HBV) DNA

409
Q

Hepatitis tests - Hepatitis C - Anti-HCVh - significance

A

acute, chronic, or previous infection

410
Q

Hepatitis tests - Hepatitis C - HCV RNA - significance

A

current infection

411
Q

Hepatitis tests - Hepatitis C - HCV RNA - used for?

A

-viral load testing
-blood/organ donor screening
-HCV genotyping to determine optimal treatment

412
Q

Hepatitis tests - Hepatitis D - Hepatitis D (HDV) (delta hepatitis) - IgM anti-HDV - significance

A

acute or chronic infection

413
Q

Hepatitis tests - Hepatitis D - Hepatitis D (HDV) (delta hepatitis) - IgM anti-HDV - a defective virus that can only occur in the presence of?

414
Q

Hepatitis tests - Hepatitis D - Hepatitis D (HDV) (delta hepatitis) - IgG anti-HDV - significance

A

recovery or chronic infection

415
Q

Hepatitis tests - Hepatitis D - Hepatitis D (HDV) (delta hepatitis) - HDV RNA - significance

A

current infection

416
Q

Hepatitis tests - Hepatitis D - Hepatitis D (HDV) (delta hepatitis) - HDV RNA - marker of?

A

viral replication

417
Q

Hepatitis tests - Hepatitis D - Hepatitis D (HDV) (delta hepatitis) - HDV RNA - used to?

A

monitor therapy

418
Q

Hepatitis tests - Hepatitis E - tests

A

tests are not currently approved by the FDA for use in the US

419
Q

Hepatitis serological profiles - Acute Hepatitis A

A

IgM anti-HAV +

420
Q

Hepatitis serological profiles - Recovery from Hepatitis A

A

Total anti-HAV +

421
Q

Hepatitis serological profiles - Acute Hepatitis B

A

HBsAg +
Total anti-HBc +
IgM anti-HBc +
Anti-HBs -

422
Q

Hepatitis serological profiles - Recovery from Hepatitis B

A

HBs Ag -
Total anti-HBc +
Anti-HBs +

423
Q

Hepatitis serological profiles - Chronic Hepatitis B/Carrier

A

HBsAg +
Total anti-HBc +
IgM anti-HBc -
Anti-HBs -

424
Q

Hepatitis serological profiles - Hepatitis B immunization

A

HBsAg -
Anti-HBc -
Anti-HBs +

425
Q

Appearance of HIV markers - Viral RNA

A

detectable within days of infection

426
Q

Appearance of HIV markers - p24 ag

A

-core coat for nucleic acids
-detectable in 2-3 weeks
-becomes undetectable as antibodies develop, then detectable again in late stages as immune system fails & virus replicates

427
Q

Appearance of HIV markers - IgM ab

A

-usually detectable in 2-8 weeks
-transient
-peaks in about 1-2 weeks
-undetectable about 1-2 weeks later

428
Q

Appearance of HIV markers - IgG ab

A

-detectable shortly after IgM
-gradual increase in titer over several months
-long lasting

429
Q

HIV screening tests - ELISA/CLIA - 1st generation - detect

A

IgG ab to HIV-1

430
Q

HIV screening tests - ELISA/CLIA - 1st generation - window period

A

6-12 weeks

431
Q

HIV screening tests - ELISA/CLIA - 2nd generation - detect

A

IgG ab to HIV-1/2

432
Q

HIV screening tests - ELISA/CLIA - 2nd generation - window period

A

6-12 weeks

433
Q

HIV screening tests - ELISA/CLIA - 3rd generation - detect

A

IgG & IgM ab to HIV-1/2

434
Q

HIV screening tests - ELISA/CLIA - 3rd generation - window period

435
Q

HIV screening tests - ELISA/CLIA - 4th generation - detect

A

IgG & IgM ab to HIV-1/2 and pg24 ag

436
Q

HIV screening tests - ELISA/CLIA - 4th generation - window period

437
Q

HIV screening tests - ELISA/CLIA - 5th generation - detect

A

-IgG & IgM ab to HIV but differentiates HIV-1 from HIV-2
-also detects p24 ag

438
Q

HIV screening tests - ELISA/CLIA - acute infection

A

P24 ag without HIV ab

439
Q

HIV screening tests - ELISA/CLIA - establish infection

A

P24 ag & HIV ab

440
Q

HIV screening tests - rapid tests - detects

A

IgG & IgM ab to HIV

441
Q

HIV screening tests - rapid tests - window period

A

4-12 weeks

442
Q

HIV screening tests - rapid tests - assays

A

immunochromatographic

443
Q

HIV screening tests - rapid tests - samples

A

whole blood, serum, oral fluid

444
Q

HIV screening tests - Nucleic acid amplification testing (NAAT) - detects

445
Q

HIV screening tests - Nucleic acid amplification testing (NAAT) - window period

446
Q

List the causes of false positives with HIV-antibody ELISA testing.

A

-heat inactivation of serum
-repeated freezing/thawing of serum
-autoantibodies
-multiple pregnancies
-liver disease
-administration of Ig
-administration of certain vaccines
-some malignancies

447
Q

List the causes of false negatives with HIV-antibody ELISA testing.

A

-blood drawn before seroconversion (window period)
-hypogammaglobulinemia
-immunosuppressive therapy
-strain of HIV not detected by assay
-technical errors

448
Q

HIV supplemental tests - Western blot (WB) - detects

A

antibody to HIV

449
Q

HIV supplemental tests - Western blot (WB) - positive

A

Report positive if at least 2 of the following 3 bands are present:
-p24
-gp41
-gp1220/160

450
Q

HIV supplemental tests - Western blot (WB) - negative

A

NAAT required following negative or indeterminant results

451
Q

HIV supplemental tests - Western blot (WB) - disadvantages

A

-time-consuming
-difficult to interpret

452
Q

HIV supplemental tests - NAAT - detects

453
Q

HIV supplemental tests - NAAT - useful when?

A

serology results are inconclusive

454
Q

Tests to stage and monitor HIV - CD4 T-cell count

A

-HIV infects CD4 cells
-Number declines as disease progresses
-<200/uL defines stage 3 infection
-also used to monitor therapy
-perform every 3-6 months
-flow cytometry is gold standard

455
Q

Tests to stage and monitor HIV - HIV-1 viral load assays: PCR (RT-PCR and qPCR); branched chain DNA assay (bDNA)

A

-quantitative methods to determine plasma HIV RNA
-used to predict disease progression, determine when to start antiretroviral therapy, & monitor response to therapy
-qPCR most frequently performed
-bDNA assays are used in labs with high testing volumes
-test 2-8 weeks after start of therapy & then every 3-4 months
-same assay should be used in order to assess changes

456
Q

Screening tests for Systemic Lupus Erythematosus (SLE) - Antinuclear antibody (ANA) - method

A

-indirect immunofluorescence (IIF)
-substrate is human epithelial cell line (Hep-2)
-high sensitivity (95-100%) but low specificity
-dilutions tested to eliminate low titer reaction in normal population
-cutoff dilution to report positive usually >=1:80
-endpoint titer may be reported
-generally higher in SLE

457
Q

Screening tests for Systemic Lupus Erythematosus (SLE) - Antinuclear antibody (ANA) - detects?

A

auto-antibodies to nuclear antigen - staining patterns reported

458
Q

Screening tests for Systemic Lupus Erythematosus (SLE) - Antinuclear antibody (ANA) - disadvantages

A

-labor intensive
-subjective

459
Q

Screening tests for Systemic Lupus Erythematosus (SLE) - Complement (C3) EIA - method

460
Q

Screening tests for Systemic Lupus Erythematosus (SLE) - Complement (C3) EIA - C3

A

C3 is turned over rapidly in SLE patients, especially during flare-ups, will see a decrease in serum C3 levels

461
Q

Screening tests for Systemic Lupus Erythematosus (SLE) - urinalysis - method

462
Q

Screening tests for Systemic Lupus Erythematosus (SLE) - urinalysis - looking for?

A

RBCs and protein to screen for kidney damage causes by Ag-autoAb complexes

463
Q

Tests for specific antinuclear antibodies (ANA) - Anti-dsDNA - sensitivity for SLE

464
Q

Tests for specific antinuclear antibodies (ANA) - Anti-dsDNA - specificity for SLE

A

high

(uncommon in other diseases or normal individuals)

465
Q

What antibody is the most specific antibody for SLE?

A

Anti-dsDNA

466
Q

Tests for specific antinuclear antibodies (ANA) - Anti-dsDNA - titers

A

correlate with disease activity

467
Q

Tests for specific antinuclear antibodies (ANA) - Anti-dsDNA - IIF patterns

A

peripheral or homogeneous fluorescent pattern

468
Q

Tests for specific antinuclear antibodies (ANA) - Anti-Sm - sensitivity for SLE

469
Q

Tests for specific antinuclear antibodies (ANA) - Anti-Sm - specificity for SLE

470
Q

Tests for specific antinuclear antibodies (ANA) - Anti-Sm - IIF pattern

A

coarsely speckled pattern

471
Q

Tests for specific antinuclear antibodies (ANA) - Anti-Sm - test methods

A

EIA, immunodiffusion, IIF

472
Q

Tests for specific antinuclear antibodies (ANA) - Anti-dsDNA - test methods

473
Q

Tests for specific antinuclear antibodies (ANA) - Antihistone, anti-DNP, anti-SS-A/R0, anti-SS-B/La, anti-nRNP - sensitivity

474
Q

Tests for specific antinuclear antibodies (ANA) - Antihistone, anti-DNP, anti-SS-A/R0, anti-SS-B/La, anti-nRNP - specificity for SLE

475
Q

Tests for specific antinuclear antibodies (ANA) - Antihistone, anti-DNP, anti-SS-A/R0, anti-SS-B/La, anti-nRNP - diagnosis

A

-generally not useful for Dx of SLE
-used to Dx other connective tissue diseases (Sjogren syndrome)

476
Q

Tests for specific antinuclear antibodies (ANA) - Antihistone, anti-DNP, anti-SS-A/R0, anti-SS-B/La, anti-nRNP - method

A

IIF, EIA, immunodiffusion

477
Q

Tests for specific antinuclear antibodies (ANA) - Extractable nuclear antigen (ENA) - sensitivity for SLE

478
Q

Tests for specific antinuclear antibodies (ANA) - Extractable nuclear antigen (ENA) - specificity for SLE

A

anti-Sm is specific for SLE

479
Q

Tests for specific antinuclear antibodies (ANA) - Extractable nuclear antigen (ENA) - method

A

immunodiffusion (Ouchterlony double diffusion) test panel that typically tests for antibodies to Smith (Sm), SS-A/R0, SS-B/La, Ribonucleoprotein (RNP)
-precipitin lines of identity/nonidentity

-new method: multiplex bead assay - immunoassay using specific antigen-coated beads & flow cytometry to detect multiple (currently 6-13) ANAs simultaneously

480
Q

Serological tests for Rheumatoid Arthritis (RA) - Rheumatoid factor (RF) - common method(s)

A

agglutination, ELISA, nephelometry

481
Q

Serological tests for Rheumatoid Arthritis (RA) - Rheumatoid factor (RF) - autoantibody

A

autoantibody (usually IgM) against IgG

482
Q

Serological tests for Rheumatoid Arthritis (RA) - Rheumatoid factor (RF) - specificity

483
Q

Serological tests for Rheumatoid Arthritis (RA) - Rheumatoid factor (RF) - agglutination tests

A

only detect IgM RF

484
Q

Serological tests for Rheumatoid Arthritis (RA) - Rheumatoid factor (RF) - ELISA & nephelometry

A

detect IgM, IgA, & IgG classes of RF

485
Q

Serological tests for Rheumatoid Arthritis (RA) - Rheumatoid factor (RF) - positive in what percentage of patients with RA?

486
Q

Serological tests for Rheumatoid Arthritis (RA) - Anti-cyclic citrullinated peptide antibody (Anti-CCP) - common method(s)

487
Q

Serological tests for Rheumatoid Arthritis (RA) - Anti-cyclic citrullinated peptide antibody (Anti-CCP) - specificity

A

more specific for RA than RF

488
Q

Autoimmune diseases - Systemic Lupus Erythematosus (SLE) - target cells and tissues

A

Multiple: kidneys, joints, skin, brain, heart, lungs

489
Q

Autoimmune diseases - Systemic Lupus Erythematosus (SLE) - laboratory findings

A

-autoantibodies to dsDNA and other nuclear components
-also see decreased serum C3
-increased CRP & ESR
-RBCs/protein in ruine

490
Q

Autoimmune diseases - Systemic Lupus Erythematosus (SLE) - abnormal CBC values

A

-decreased HGB & HCT
-low WBC and platelet count

491
Q

Autoimmune diseases - Rheumatoid Arthritis (RA) - target cells and tissues

A

joints, bone, and other connective tissue

492
Q

Autoimmune diseases - Rheumatoid Arthritis (RA) - laboratory findings

A

-anti-CCP most diagnostic
-rheumatoid factor
-positive ANA titer
-elevated CRP, ESR
-decreased C3

used to monitor treatment

493
Q

Autoimmune diseases - Wegener Granulomatosis - target cells and tissues

A

upper respiratory system, lungs, and blood vessels

494
Q

Autoimmune diseases - Wegener Granulomatosis - laboratory findings

A

-positive antineutrophil cytoplasmic antibody (ANCAs)
-glomerulonephritis

495
Q

Autoimmune diseases - Wegener Granulomatosis - severity

A

rare but severe due to chronic activation of neutrophils, T cells, and B cells

496
Q

Autoimmune diseases - Scleroderma - target cells and tissues

A

skin and blood vessels - fibrosis can occur in vessels of most organs

497
Q

Autoimmune diseases - Scleroderma - laboratory findings

A

-Scl-70 autoantibodies
-speckled/nucleolar ANA pattern
-Raynaud’s phenomenon common

498
Q

Autoimmune diseases - Sjogren Syndrome - target cells and tissues

A

lacrimal and salivary glands

499
Q

Autoimmune diseases - Sjogren Syndrome - laboratory findings

A

autoantibodies toward RNA complexed with cellular proteins (SS-A/Ro and SS-B/La)

500
Q

Autoimmune diseases - Sjogren Syndrome - can occur with what other diseases?

A

SLE and RA

501
Q

Autoimmune diseases - Graves’ Disease - target cells and tissues

A

thyroid gland (commonly TSH receptors)

502
Q

Autoimmune diseases - Graves’ Disease - laboratory findings

A

-decreased TSH
-increased T4
-TSH receptor autoantibodies
-may see thyroglobulin & TPO autoantibodies

503
Q

Autoimmune diseases - Graves’ Disease - diagnostic in 99% of patients?

A

TSH receptor autoantibodies

504
Q

Autoimmune diseases - Hashimoto Thyroiditis - target cells and tissues

A

thyroid gland (eipthelial cells)

505
Q

Autoimmune diseases - Hashimoto Thyroiditis - laboratory findings

A

-increased TSH
-decreased T4
-TPO & thyroglobulin autoantibodies in most patients

506
Q

Autoimmune diseases - Hashimoto Thyroiditis - diagnostic?

A

microsomal autoantibodies

507
Q

Immunodeficiency diseases - Severe Combined Immunodeficiency (SCID) - immune component deficient

A

adaptive arm, IL-2 receptor mutation

508
Q

Immunodeficiency diseases - Severe Combined Immunodeficiency (SCID) - laboratory findings

A

decreased and/or non-functional T cells and B cells

509
Q

Immunodeficiency diseases - Severe Combined Immunodeficiency (SCID) - confirmation

A

genetic tests

510
Q

Immunodeficiency diseases - Wiskott-Aldrich Syndrome - immune component deficient

A

cellular arm of immune system (mainly T cells but then B cells can’t form antibodies)

511
Q

Immunodeficiency diseases - Wiskott-Aldrich Syndrome - laboratory findings

A

-decreased platelet numbers and size
-decreased IgM (to ABO antigens, can be diagnostic)
-elevated serum alpha fetoprotein (AFP)

512
Q

Immunodeficiency diseases - Wiskott-Aldrich Syndrome - patients often have?

A

severe eczema

513
Q

Immunodeficiency diseases - DiGeorge Anomaly - immune component deficient

A

chromosome 22 mutation, defective thymus or lack of thymus

514
Q

Immunodeficiency diseases - DiGeorge Anomaly - laboratory findings

A

partial or complete lack of T cells

515
Q

Immunodeficiency diseases - Ataxia Telangiectasia (AT) - immune component deficient

A

chromosomal breaks occur, inhibiting VDJ rearrangement for T and B cells

516
Q

Immunodeficiency diseases - Ataxia Telangiectasia (AT) - laboratory findings

A

-decreased circulating T cells
-decreased levels of IgA, IgE, and IgG2
-increased serum AFP

517
Q

Immunodeficiency diseases - Ataxia Telangiectasia (AT) - physical manifestations

A

ataxia and capillary swelling/red blotches

518
Q

Immunodeficiency diseases - X-linked Bruton Tyrosine Kinase Deficiency - immune component deficient

A

antibody immunodeficiency, lack of CD19+ cells and all subsequent cells (plasma and memory cells)

519
Q

Immunodeficiency diseases - X-linked Bruton Tyrosine Kinase Deficiency - laboratory findings

A

-lack of CD19+ cells via flow cytometry
-decreased or lack of IgA, IgE, IgG, IgM

520
Q

Immunodeficiency diseases - Selective IgA Deficiency - immune component deficient

A

IgA only is deficient

521
Q

Immunodeficiency diseases - Selective IgA Deficiency - laboratory findings

A

lack of serum IgA

522
Q

Immunodeficiency diseases - Selective IgA Deficiency - physical findings

A

recurrent respiratory and GI infections

523
Q

Immunodeficiency diseases - Chediak Higashi Syndrome - immune component deficient

A

NK cells/neutrophils

524
Q

Immunodeficiency diseases - Chediak Higashi Syndrome - laboratory findings

A

-differential shows leukocytes with enlarged granules
-increased acute phase proteins and cytokines

525
Q

Immunodeficiency diseases - Chronic Granulomatous Disease - immune component deficient

A

neutrophil microbiocidal function

526
Q

Immunodeficiency diseases - Chronic Granulomatous Disease - laboratory findings

A

DHR/flow cytometry (decreased fluorescence)

527
Q

Immunodeficiency diseases - Chronic Granulomatous Disease - increased susceptibility to?

A

pyogenic infections

528
Q

Immunodeficiency diseases - Leukocyte Adhesion Deficiency - immune component deficient

A

CD18 on phagocytic cells

529
Q

Immunodeficiency diseases - Leukocyte Adhesion Deficiency - laboratory findings

A

decreased CD18 on dendritic cells (measured by flow cytometry)

530
Q

Immunodeficiency diseases - Leukocyte Adhesion Deficiency - physical findings

A

-delayed wound healing
-chronic skin, intestinal, and respiratory tract infections

531
Q

Interpretation of serological tests -
titer concentration

A

> =4-fold increase in titer from acute to convalescent specimen drawn 10-14 days later is diagnostic

532
Q

Interpretation of serological tests - IgM ab

A

sign of recent infection

533
Q

Interpretation of serological tests - IgG ab

A

sign of immunity

534
Q

Interpretation of serological tests - IgG ab in newborn

A

is maternal antibody

535
Q

How would you prepare a 5% suspension of human group O RBCs?

A

5% = 5 mL per 100 mL

Mix 5 mL of packed RBCs + 95 mL of buffer.
For a smaller amount: 0.5 mL of packed RBCs + 9.5 mL buffer

Any 1:20 dilution could be used (5:100 = 1:20)

536
Q

How would you prepare 5 mL of a 1:10 dilution of serum?

A

(1/10) = (x/5)
10x = 5
x = 0.5 mL

0.5 mL diluted to 5 mL is a 1:10 dilution, so mix 0.5 mL serum + 4.5 mL of buffer

537
Q

How would you prepare 10 mL of a 1:100 dilution from a 1:10 dilution?

A

A. Determine the dilution factor to make a 1:100 dilution from a 1:10 dilution:
1/10 x 1/x = 1/100
1/10x = 1/100
10x = 100
x = 10
A 1:10 dilution of a 1:10 dilution yields a 1:100 dilution (1/10 x1/10 = 1/100)

B. Determine how to make 10 mL of a 1:10 dilution:
1:10 dilution is 1 part + 9 parts

To make 10 mL, mix 1 mL of solution + 9 mL of buffer.

To make 10 mL of a 1:100 dilution from a 1:10 dilution, mix 1 mL of the 1:10 dilution + 9 mL of buffer

538
Q

What is the dilution in tube 4 of a 2-fold serial dilution, if tube 1 is undiluted?

A

1 x 1/2 x 1/2 x 1/2 = 1/8

539
Q

Which cell of the innate immune system has granules that contain bactericidal enzymes?

A. Dendritic cell
B. Neutrophil
C. T cell
D. Mast cell

A

B. Neutrophil

540
Q

Which part of an antibody molecule is responsible for complement fixation and opsonization?

A. Fc fragment
B. Fab fragment
C. Light chain
D. Joining (J) chain

A

A. Fc fragment

541
Q

Which hypersensitivity reaction is predominantly mediated by T cells?

A. Type I
B. Type II
C. Type III
D. Type IV

A

D. Type IV

542
Q

From the following list, which test is most specific for RA?

A. Anti-dsDNA
B. Rheumatoid factor (RF)
C. Anticyclic citrullinated peptide (CCP)
D. Anti-SS-A/Ro

A

C. Anticyclic citrullinated peptide (CCP)

543
Q

Which HIV marker is detectable within days of infection in patient serum?

A. Viral RNA
B. P24 antigen
C. IgM antibody
D. IgG antibody

A

A. Viral RNA

544
Q

Which is the first antibody detected in serum after infection with hepatitis B?

A. Anti-HBe
B. Anti-HBc IgM
C. Anti-HBs
D. HBeAg

A

B. Anti-HBc IgM

545
Q

In infectious mononucleosis, which of the following antibodies would be detected earliest during acute infection?

A. Anti-VCA IgM
B. Anti-EBNA
C. Heterophile antibodies
D. Anti-EA IgG

A

A. Anti-VCA IgM

546
Q

Which of the following is a cause of a biological false-positive in the nontreponemal assays for syphilis?

A. Infectious mononucleosis
B. Rheumatoid arthritis
C. pregnancy
D. All of the above

A

D. All of the above

547
Q

In which assay can a high concentration of antigen (analyte) cause hook effect?

A. EMIT
B. FPIA
C. Sandwich ELISA
D. TP-PA

A

C. Sandwich ELISA

548
Q

Which type of immunoassay does NOT require a separation step?

A. Noncompetitive
B. Homogenous
C. Heterogenous
D. All of the above

A

B. Homogenous

AMT MT Exam (12 decks)

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