Clin Lab 4 Immunology

Front 1

What immunity is naturally occurring, non-specific, and includes natural barriers like skin, phagocytes, mucous membranes, and normal flora?

Back 1

Innate Immunity

Front 2

What immune response Protects the body the same way each time, regardless of the nature of the organism, Usually involves external defenses,A rapid defense action occurs and Non-specific

Back 2

Innate Immunity

Front 3

An immune response that develops memory to specific organisms or molecules is

Back 3

Adaptive Immunity

Front 4

What are some examples of Adaptive Immunity?

Back 4

- Humoral immunity (B-cells & antibody production)
- Cell-mediated immunity (T cells—CD4/8)

Front 5

What is the difference between Humoral and Cellular immunity?

Back 5

- Humoral immunity is concerned with antigen-antibody reactions
- Cellular immunity is directly related to cells, cell-to-cell contact, and cytotoxic cells

Front 6

What cell acts as a phagocyte, as well as processes and presents antigens to CD4 cells via Major Histocompatibility Complex (MHC) Class II molecule?

Back 6

- Macrophage

Front 7

Upon stimulation with antigens, what do CD4 cells secrete in response to contact with the MHC II molecule?

Back 7

Cytokines

Front 8

What are cytokines?

Back 8

Small protein molecules secreted by immune cells that control the action of other immune cells

Front 9

Upon antigen contact, what do Mast cells release that cause local inflammation in tissues?

Back 9

Histamine

Front 10

What gland differentiates stem cells to T-cells?

Back 10

Thymus gland

Front 11

Loss of what cell in AIDS patients results in the inability to mount an effective immune response?

Back 11

T-Helper Lymphocytes (aka CD4 cells)

Front 12

when Infected cells and cells tagged for destruction (express a particular antigen via the MHC I molecules) are signaled to be killed, what cell activates this response?

Back 12

T-Helper Lymphocyte

Front 13

Once activated by the MHC I molecules, what cells are signaled to destroy tagged/infected cells?

Back 13

- B lymphocytes
- Cytotoxic T-cells (CD 8 Lymphocytes)

Front 14

After stimulated by cytokines and T-helper cells, what do B-cells differentiate into? What do they produce?

Back 14

Plasma cells; Antibodies

Front 15

What is the basic structure of antibodies?

Back 15

2 light chains & 2 heavy chains

Front 16

When stimulated, what cell will secrete cytokines that suppress the immune response

Back 16

T-Suppressor Lymphocytes (various CD markers)

Front 17

AIDS patients have an “inverted"

Back 17

T helper to T suppressor ratio

Front 18

Where are B-Lymphs produced

Back 18

in the bone marrow

Front 19

In Adaptive Immunity, when does the Primary immune response occur

Back 19

first exposure of the adaptive immune system to an antigen results in a slow rise in titer of antibodies against the antigen

Front 20

In Adaptive Immunity, when does Secondary immune response occur

Back 20

A second exposure to the same antigen results in an immediate and very high rise in antibody titer (IgG), Usually protective or results in a very mild or sub-clinical

Front 21

Describe the Primary Immune Response

Back 21

– IgM immunoglobulins are produced first, followed by a slow rise in IgG titers; many memory lymphocytes remain after the primary infection has resolved

Front 22

What are lymphocytes with no B or T cell markers that are responsible for killing foreign cells or cells coated with antibodies?

Back 22

Natural Killer Cells

Front 23

How can T-suppressor lymphocytes be used as a CD marker?

Back 23

The progression of HIV to AIDS can be seen as the ratio of T-Helper to T-Suppressor cells becomes “inverted” (i.e. there are more T-Suppressor cells than T-Helper cells)

Front 24

The Fb portion of an antibody is designed to bind to a specific antigen (usually foreign). What does the Fc portion of the IgE immunoglobulin bind to?

Back 24

Mast cells (to produce histamine)

Front 25

1- What antibodies bind at complement? 2- Which antibody is best at fixing complement?

Back 25

(1) IgG & IgM

(2) IgM

Front 26

What antibody is commonly found in secretions?

Back 26

IgA

Front 27

What immunoglobulin has the largest population in circulation and can cross the placenta, allowing it to enter fetal circulation?

Back 27

IgG

Front 28

Which antibody is not detectable in circulation, but stays attached to B cells?

Back 28

IgD

Front 29

Which immunoglobulin is a pentameric molecule?

Back 29

IgM

Front 30

What antibody will typically increase in numbers when responding to a parasitic infection, but is not typically detectable in circulation?

Back 30

IgE

Front 31

Complement is a group of at least 20 immunologically distinct proteins involved in the “Complement Cascade.” One the proteins in the Complement Cascade is C3b, which stimulates phagocytic cells into phagocytosis. What is this function of C3b called?

Back 31

Opsonization

Front 32

How is Complement primarily activated?

Back 32

Antigen-antibody reactions

Front 33

C3b leads to the formation of C5, C6, C7, C8, and C9. These proteins work together to puncture a hole in the membrane of a target cell. What is this complex of complement proteins called?

Back 33

Membrane Attack Complex (MAC)

Front 34

The function of complement protein C5a is to attract and activate neutrophils and mast cells, causing inflammation. What is this attraction called?

Back 34

Chemotaxis

Front 35

There are a variety of different immunodeficiencies. One of these involves a deficiency of complement (especially proteins C1, C2, and C4). What is this immunodeficiency?

Back 35

Phagocytic cell defects

Front 36

Agammaglobulinemia and Hypogammaglobulinemia is involved in what immunodeficiency?

Back 36

B-cell deficiency

Front 37

Failure of the thymus to develop (resulting in poor cell-mediated immunity) causes which immunodeficiency?

Back 37

T-cell deficiency

Front 38

What is an immune deficiency caused by viruses, exposure to certain chemicals or radiation?

Back 38

Acquired Immunodeficiency

Front 39

Which immunodeficiency can potentially be rapidly fatal from a lack of enzymes that produce T and B cell receptors?

Back 39

Combined Immunodeficiency

Front 40

Which types of hypersensitivity reaction is immediate and involves IgE-coated mast cells releasing vasoactive amines and Smooth muscle contraction and vascular permeability increase dramatically

Back 40

Type I Hypersensitivity

Front 41

Which hypersensitivity has a delayed reaction (usually 24-72 hours) and involves T-cells recruiting macrophages and basophils to ANTIGEN presenting tissues (such as in a PPD skin test)?

Back 41

Type IV Hypersensitivity

Front 42

What hypersensitivity type involves killer cells destroying any cell coated with antibodies (as seen in Hemolytic Disease of the Newborn)?

Back 42

Type II Hypersensitivity

Front 43

An example of Type III Hypersensitivity involves foreign Ag coated Ab lodged in the basement membrane of the glomerulus. The antigen-antibody complex activates complement upon the cells of the glomerulus, thus causing damage. What is this disease called?

Back 43

Glomerulonephritis

Front 44

Hashimoto's thyroiditis pathology results from antibodies generated against thyroid tissue is an example of what type of Autoimmune Disease

Back 44

Organ-Specific

Front 45

Systemic Lupus Erythematosis (SLE), a systemic autoimmune disease that affects the entire body with no one specific organ involved is an example of what type of Autoimmune Disease

Back 45

Non-Organ Specific

Front 46

What is a screening test used to determine if a patient has Syphilis?

Back 46

Rapid Plasmin Reagin (RPR)

Front 47

When conducting a RPR test, plasmin reagin is placed on a test card and gently mixed with a sample of the patient’s serum. What happens when the patient tests positive on the RPR? What treatment should be given to the patient with a positive RPR?

Back 47

- Agglutination
- All positive test results must be confirmed by FTA ABS
- (other diseases can cause a positive RPR test result)

Front 48

Where RPR testing can be useful for screening and monitoring Syphilis, what other test can be helpful in detecting plasmin reagin in both serum and CSF samples?

Back 48

Venereal Disease Research Laboratory (VDRL) test

Front 49

What test is positive for Syphilis when viewing the presence of fluorescing dead Treponema pallidum antigens on the slide

Back 49

Fluorescent Treponemal Antibody Absorption test (FTA ABS)

Front 50

Samples for Chlamydia testing are obtained via urethral swab. What are two exams that can detect Chlamydia antigens?

Back 50

- Enzyme Immunoassay (EIA) –
- Fluorescent Antibody Staining –

Front 51

How can you tell if the Enzyme Immunoassay (EIA) test is positive for the Chlamydia antigen?

Back 51

- Color change will occur in the presence of antigen-antibody reaction, indicating a positive test
- Color change is directly proportional to the amount of Chlamydia in the sample

Front 52

ow can you tell if theFluorescent Antibody Staining test is positive for the Chlamydia antigen?

Back 52

Sample is observed under microscope for fluorescence (positive test)

Front 53

(HSV) Type I is primarily found

Back 53

in vesicles located around the mouth and nose

Front 54

(HSV) Type II is primarily found

Back 54

in mucous membranes around the genital area

Front 55

What is the most commonly performed test for the diagnosis of acute HSV infection

Back 55

Viral culture

Front 56

what is the first Ab produced, has
Five antibody subunits bound together, Excellent at fixing complement, Many blood group antibodies are in this class

Back 56

IgM

Front 57

What should you consider when attempting to collect a quality (HSV) sample for culture?

Back 57

- The culture must be obtained from the base of the skin lesion
- The sample should be collected as early as possible in the course of the lesion to increase quantity of virus available in the sample.

Front 58

What confirmatory test is most often performed after a positive (HSV) viral culture?

Back 58

Enzyme Immunoassay (EIA)

Front 59

There is a retrovirus that infects CD4 cells and is transmitted in semen, as well as other body fluids. Antibodies to the virus typically appear 2 to 4 weeks after exposure. What is this virus?

Back 59

Human Immunodeficiency Virus (HIV)

Front 60

What test is used to screen for infection of (HIV) virus?

Back 60

Enzyme Immunoassay (EIA)

Front 61

If EIA results are positive for HIV, what test is used to confirm the results?

Back 61

Western Blot Test

Front 62

How are these band patterns interpreted in a Western Blot Test?

Back 62

Negative – No bands are present Positive – Bands are present in the diagnostic pattern – This confirms the patient is infected with HIV
Indeterminate – Bands are present without pattern – inconclusive and need to be repeated (w/in several weeks)

Front 63

How are you able to determine susceptibility to Diphtheria

Back 63

- Schick Test
- A patient is susceptible (NOT immune) to the diphtheria toxin if the exposed area become red within 4 to 7 days

Front 64

Diphtheria is a bacterial infection that can cause cell death and tissue necrosis. This infection is caused by what GP bacteria

Back 64

Corynebacterium diphtheriae

Front 65

Typhoid fever is caused by fecal-oral transmission of what orgamism

Back 65

Salmonella typhi

Front 66

What test is used to detect antibodies to S. typhi by direct agglutination

Back 66

Widal test

Front 67

What is indicated from a positive Widal test, and why is it not frequently used?

Back 67

- Positive Widal test indicates that the patient is a carrier or has been exposed to Salmonella typhi
- Negative test result does NOT indicate that the patient is NOT infected or carrying S. typhi

Front 68

What test would be used to determine if a patient has developed antibodies for Rocky Mountain Spotted Fever (R. rickettsii)?

Back 68

Weil-Felix test

Front 69

The patient produces antibodies to different species of rickettsia that cross-react with antigens (called OX antigens) from

Back 69

Proteus vulgaris

Front 70

A meningitis panel is based on visible agglutination. What body fluid needs to be collected from the patient for this test? What particles are the antibodies bound to in the agglutination test?

Back 70

- CSF
- Latex or Charcoal particles

Front 71

Strep Group A antigens can be detected by an

Back 71

- Agglutination test
All swabs should be confirmed with a culture

Front 72

Group A Beta Strep can be screened with a

Back 72

- Rapid Strep Test

Front 73

If the Strep Group A test results are positive, what test should be conducted for confirmation?

Back 73

All swabs should be confirmed with a culture ( beta hemolysis )

Front 74

What is indicated by a positive and a negative Agglutination test?

Back 74

- Positive test results indicate that antibiotic therapy can be initiated
- Negative test results do NOT rule out infection, it indicates a lack of antibodies

Front 75

A positive Antistreptolysin O (ASO) Titer indicates prior infection with

Back 75

Group A Beta Strep

Front 76

What diseases other than Group A Beta Strep can cause an increased ASO Titer?

Back 76

- Acute Rheumatic Fever &

- Post-Streptococcal Glomerulonephritis

Front 77

Infectious Mononucleosis is caused by what pathogen?

Back 77

Epstein-Barr Virus (EBV)

Front 78

What is the qualitative (screening) test used for detection of heterophile antibodies against EBV?

Back 78

Mono-Spot Test

Front 79

When a Mono-Spot Test result comes back negative, what should be considered?

Back 79

- the test was conducted too early in the infection cycle
- should be repeated in 1-2 weeks if the patient’s symptoms persist

Front 80

Purified Protein Derivative antigen is used to aid in the diagnosis of what disease?

Back 80

Tuberculosis

Front 81

A positive Purified Protein Derivative (PPD) Skin test is caused by what type of immune response?

Back 81

Cell-Mediated Immune Response,
Type IV Hypersensitivity

Front 82

A positive PPD Skin test can be diagnosed if the site of injection has

Back 82

an induration >2cm (20mm) in diameter.

Front 83

The main value of a Fungal Serology test is

Back 83

that immunocompromised individuals show a negative test. This is because they can no longer respond to the fungal antigen—thus making it possible to detect immunodeficiency

Front 84

Fungal Serology test how is Canidida albicans given

Back 84

It's injected under the skin

Front 85

When considering fungal serology, Cryptococcosis, Histoplasmosis, Blaastomycosis, and Coccidiodomycosis are all infections that produce antibodies that are detected by what test?

Back 85

EIA

Front 86

Two titers are collected when conducting viral serology tests: acute and convalescent. Which titer is submitted to the lab first and what the procedure then after?

Back 86

- The acute titer is collected during the acute phase of the infection, then frozen until the convalescent titer is collected 2 weeks later.
- After the convalescent titer is collected both titers are submitted to the lab at the same time

Front 87

How do you determine a positive result in a viral serology test?

Back 87

If the convalescent titer has a 4-fold increase in antibody titer from acute to convalescent specimens is positive for viral infection.

Front 88

Which hepatitis viruses antibody is typically found during the acute phase of a hepatitis infection and is NOT considered protective?

Back 88

IgM

Front 89

What is indicated if IgG anti-HAV antibodies are present in a patient’s blood?

Back 89

Past infection and immunity—no chronic infection exists for HAV since the antibodies produced confer lifelong immunity

Front 90

Which HBV antigen(s) is used to determine acute and chronic infection?

Back 90

HBsAg (Hepatitis B surface Antigen) & HBcAg (Hepatitis B core Antigen)

Front 91

Which HBV antigen is a reliable marker of current or past infection?

Back 91

HBcAg

Front 92

What antibody is not protective and indicates active viral replication (acute illness)?

Back 92

IgM (Anti-HBc)

Front 93

Which antibody indicates immunity to HBV?

Back 93

HBsAb (Hepatitis B surface antibody)

Front 94

Presence of Anti-HCV in a blood sample may indicate that the patient has been infected with HCV. What the a confirmatory test?

Back 94

Anti-HCV (RIBA)

Front 95

Recombinant ImmunoBlot Assay (RIBA) is a type of Western Blot test that indicates if the patient has been infected. What test need to be conducted to determine patient infectivity?

Back 95

HCV-RNA (indicates infectivity and may be used to diagnose chronic infection)

Front 96

Identify the immunogenic substance that is non-infectious and is given to stimulate a protective, adaptive immune response to an infectious organism.

Back 96

A Vaccine

Front 97

administration of immunogens that cause an adaptive immune response which results in a long-term immunity

Back 97

Active immunization

Front 98

administration of antibodies to a specific organism that bind to infectious organisms in vivo for a short-term immunity

Back 98

Passive immunization

Front 99

What is the mechanism of immunoprophylaxis?

Back 99

An immunogen is administered with the intent that the individual’s adaptive immune response will mount a defense,if the individual come in contact w/ the organism again contact with the organism and prevent infection

Front 100

A form of passive immunity, usually administered to a patient who already has the disease, helps negate the effects of the toxin being produced

Back 100

antitoxin

Front 101

A vaccine containing a bacterial toxin that has been inactivated but still possesses immunogenic activity

Back 101

toxoid vaccine

Front 102

What type of vaccine contains a non-infectious agent that has similar antigens to a disease-causing organism (e.g. the smallpox vaccine)?

Back 102

Heterologous Vaccine

Front 103

Live vaccines contain live but weakened viruses( live attenuated viruses). What are some precautions that should be taken with live vaccines?

Back 103

Live vaccines should not be administered to immunocompromised individuals or individuals with hypersensitivity to eggs.

Front 104

Name the substance administered with an antigen so as to enhance its antigenicity and make a better immunogen?

Back 104

- An Adjuvant

-Al(OH)3 administered with small antigens

Front 105

What are some hazards of immunization?

Back 105

- Insufficient attenuation
- Reversion (attenuated vaccines)
- Contamination by other infectious agents
- Allergic reactions

Front 106

Additional vaccination(s) given to boost or increase the immune response to a given infectious organism

Back 106

Booster

Front 107

A vaccine containing a bacterial toxin that has been inactivated by heat or chemical alteration but still possesses immunogenic activity

Back 107

Toxoid Vaccine