Serology Day 3 - Autoimmune, immunoassays

Question 1

ANA test

Answer 1

Screening test for anti-nuclear antibodies

Question 2

Homogenous ANA pattern usually indicative of:

Answer 2

SLE (systemic lupus erythamatosus)

Question 3

Centromere (discrete speckled) ANA pattern usually indicative of:

Answer 3

Scleroderma (CREST)

Question 4

Speckled ANA pattern usually indicative of:

Answer 4

Sjogren syndrom

Question 5

Nucleolar ANA pattern usually indicative of:

Answer 5

Scleroderma

Question 6

SLE clinical presentation

Answer 6

Multi-organ involvement (skin, joints, kidney, lungs, CNS), Raynaud’s, butterfly rash, anemia, decreased platelets, increased erythrocyte sedimentation rate

Question 7

Drug-induced SLE

Answer 7

Has antibodies to histones but not to ds-DNA, shows positive on ANA but negative on Crithidia lucilae

Question 8

Crithidia lucilae

Answer 8

Single cell protozoan, has mitochondrial mass of ds-DNA, SLE antibodies react

Question 9

SLE antibodies

Answer 9

Anti-dsDNA and anti-Smith

Question 10

Sjogren’s Syndrom clinical presentation

Answer 10

Affects lacrimal and salivary glands (dry eyes and mouth, pain and swelling in glands)

Question 11

Sjogren’s Syndrome antibodies

Answer 11

Anti-La, rheumatoid factor (need biobsy of salivary glands for definitive diagnosis)

Question 12

Scleroderma 2 forms

Answer 12

Progressive diffuse, systemic CREST

Question 13

CREST meaning

Answer 13

Calcinosis (bone formation)
Raynaud
Esophogeal involvment
Sclerodactyly (hard fingers)
Telangiectasia (spider veins)

Question 14

Scleroderma clinical presentation

Answer 14

Cyanosis, puffy face, hard skin, GI symptoms, lung and heart arrythmias

Question 15

Scleroderma antibodies

Answer 15

Anti-centromere

Question 16

Insulin-dependent Diabetes Mellitus antibodies

Answer 16

Anti-beta cells, can’t produce insulin

Question 17

MIXED Connective tissue disease clinical presentation

Answer 17

Joint pain, stiffness, esophageal disfunction, progressively worsening, leukopenia, arthritis

Question 18

MIXED Connective tissue disease antibodies

Answer 18

Anti-ssDNA

Question 19

Rheumatoid arthritis clinical presentation

Answer 19

Joint swelling, morning stiffness, weight loss, fatigue, low grade fever

Question 20

Rheumatoid arthritis antibodies

Answer 20

Rheumatoid factor (IgG, IgM, IgA)

Question 21

Autoimmune hepatitis antibodies

Answer 21

Anti-liver smooth muscle

Question 22

Goodpasture’s disease antibodies

Answer 22

Anti-glomerular basement membrane

Question 23

Pernicious anemia antibodies

Answer 23

Anti-parietal cell

Question 24

Hashimoto’s Thyroiditis

Answer 24

Increased TSH, normal T3/T4, hypothyroidism

Question 25

Grave's disease

Answer 25

Increased T3/T4, decreased TSH, hyperthyroidism

Question 26

Pernicious anemia clinical signs and treatment

Answer 26

Can't absorb vitamin B12 due to destruction of parietal cells in GI, treat with injections of B12

Question 27

Autoimmune liver disease antibodies

Answer 27

Anti-liver soluble protein Anti-liver membrane Anti-acidoglycoprotein receptor

Question 28

Radioimmunoassay

Answer 28

Reactant is radiolabeled, used to look at small molecules (hormones, vitamins, drugs), not used as much anymore

Question 29

Common enzyme labels

Answer 29

Horseradish peroxidase, alkaline phosphatase, glucose-6-PD

Question 30

Common fluorescent labels

Answer 30

FITC (green), Rhodamine (orange)

Question 31

Common chemiluminescent labels

Answer 31

Acridinium esters, luminol, nitrophenyl oxalates

Question 32

Competitive immunoassays

Answer 32

Labeled antigen added, competes for space on antibody with unlabeled antigen present in patient sample, higher signal seen (labeled antigen) = lower concentration of unlabeled antigen

Question 33

Non-competitive assay

Answer 33

"Sandwich assay", wash steps to remove other antigens, higher sensitivity and specificity

Question 34

Homogeneous immunoassays

Answer 34

Don't require separation by washing (latex agglutination)

Question 35

Heterogenous immunoassays

Answer 35

Wash steps, removes other antigens (less false positives and background noise)

Question 36

Enzyme Multiplied Immunoassay Technique (EMIT)

Answer 36

Automated competitive method, used for drug testing

Question 37

Nephelometry

Answer 37

Measuring light scattering off of Ag/Ab complexes, more scattered light means more complexes

Question 38

Fluorescence light pathway

Answer 38

Incident light (high energy/small wavelength) excites molecule which gives off fluorescent light (lower energy/higher wavelength)

Question 39

Photoluminescence

Answer 39

Living/non-living, organic/non-organic specimens absorb and re-radiate light (fireflies)

Question 40

Epifluorescence

Answer 40

Combination of excitation and emission wavelengths travel through specimen to emit fluorescence (not used as much, parasitic cysts)

Question 41

What are rheumatoid factors?

Answer 41

Antibodies against the Fc region of IgG

Question 42

Billiary cirrhosis antibodies

Answer 42

Anti-mitochondrial