Autoantiboby Evaluation

Antinuclear antibody test are preformed to help diagnose:

Autoantiboby Evaluation

In the anti-double stranded DNA procedure, the antigen most commonly utilized is:

Autoantiboby Evaluation

 which Ana patterns would be associated with high titers of antibodies to the Sm antigen?

Autoantiboby Evaluation

sera to be tested for IFA-ANA 6 days after drawing is best stored at

Autoantiboby Evaluation

Antobodies directed at native DNA are most frequently associated with with what pattern of flourescence in the IFA-ANA test?

Autoantiboby Evaluation

The technologist observes apparent homogenous staining of the nucleus of interphase cells while performing an IGA-ANA, as well as staining of the chromozomes in mitotic cells. This result is:

Autoantiboby Evaluation 

The result of an anti nuclear antibody test was a titer of 1:320 with a peripheral pattern . Which of the following sets of results best correlate with these results

Autoantiboby Evaluation 

Systemic lupus erythematosis patients often have which of the following test results?

Autoantiboby Evaluation 

systemic lupus erythematosis patients with active diseases often have which of the following test results?

Marked decrease in serum CH₅₀

CH50 is a good screening test for complement deficiencies in the classical pathway . In SLE patients the classical pathway is critical for immune complex clearance.

Autoantiboby Evaluation 

What is decreased in serum during the active stages of systemic lupus erythematosis?

Complement C3

C3 becomes depleted due to the autoantibody called C3-nephritic factor.

Autoantiboby Evaluation 

A positive ANA with the pattern of anticentromere antibodies is most frequently seen in patients with:

Autoantiboby Evaluation 

In the indirect flourescent anti-nuclear antibody test , a homogenous pattern indicates the presence of antibody to:

 Autoantiboby Evaluation

In the indirect flourescent anti-nuclear antibody test, a speckled pattern may indicate the presence of antibody to:

Sm

Sm antigens is a non-histone nuclear protein composed of several polypeptides of differing molecular weights. Sm causes a speckled pattern 

Autoantiboby Evaluation

A patient has the following test results:

ANA + 1:320

ASO  50todd units

Complement  decresed

RA +

The above results could be seen in patients with:

 Autoantiboby Evaluation

Autoantibodies in the absence of Sm are found in patients with:

Autoantiboby Evaluation

To make a presumptive diagnosis of rheumatoid arthritis, which of the fllowing qualitative methods is most sensitive.

Autoantiboby Evaluation

Rheumatoid facor reacts with:

Autoantiboby Evaluation

A consistantly and repeatedly negative IFA-ANA is:

Autoantiboby Evaluation

Positive rheumatoid factor is generally associated with:

Hyperglobulinemia

Hypergammglobulinemia such as a polyclonal increase is associated with an autoimmune disorder,

Hypergammaglobulinemia such as a monoclonal increse is associated with multiple myloma.

Autoantiboby Evaluation

The following results are from a rubella titer performed on acute and convelescent sera using a 2 fold serial dilution:

date tested: 1/23/04

acute serum 1:8

convelescent serum titer 1:32

this is a two fold increase

results are consistant with active infection with rubella.

Autoantiboby Evaluation 

Rheumatoid factors are immunoglobulins with specificity for allotypic determinants located on the:

Autoantiboby Evaluation  

Rheumatoid factor  in a patients serum may cause a false:

positive test for the detection of IgM class antibodies.

IgM RF is the species most commonly measured in clinical assays.

Autoantiboby Evaluation 

Rheumatoid factors are defined as

Autoantiboby Evaluation 

Tissue injury in systemic rheumatic disorders such as systemic lupus erythematosis is thought to be caused by

deposition of immune complexes

Large soluable complexes often accumulate along the basement membrane in the kidney. Impaired ability to process and clear immune complexes in SLE

Autoantiboby Evaluation 

False positive rhematoid factor in agglutination and nephelometric methods can be due to elevated levels of :

C1q

C1q like RF will bind and cross link IgG;

cryoglobulin causes false negative.

Autoantiboby Evaluation

An acute phase protein that binds to the membrane of certian microorganosms and activates the complement system is:

Autoantiboby Evaluation

High titers if antimicrosomal antibodies are most often found in :

Thyroid disease

TPO is positive in aabout 90% of patients with chronic thyroiditis.

Autoantiboby Evaluation 

Which of the following is an organ specific autoimmune disease

Addison disease

Addisons disease has antibodies circulating to adrenal antigens.

Autoantiboby Evaluation

In chronic active hepatitis, high titers of which of the following antibodies are seen?

Autoantiboby Evaluation

In primary biliary cirrosis, what antibody is seen in high titers

Autoantiboby Evaluation 

Anti-RNA antibodies are often present in individuals having an antinuclear antibody immunoflourescent  pattern that is

Autoantiboby Evaluation

Anti- extractable nuclear antigens are most likely associated  with what anti-nuclear antibody immunoflourescence pattern

Autoantiboby Evaluation 

In an antinuclear antibody indirect immunofluorescence test, a sample of patient serum shows a positive, speckled pattern, What would be the most appropriate additional test to perform?

Autoantiboby Evaluation

 Anti glomerular basement membrane antibody is most often associated with this condition:

Autoantiboby Evaluation

A 25 year old woman is seen by a physician because of raynards phenomen, myalgias. arthralgias and difficulty in swallowing , There is no evidence of renal disease . An ANA titer is 1:5120 with a speckled pattern with mitioic. What is also likely to be found in the patient?

High levels ribonucleoprotein (RNP) antibody

RNP (raynards)

Autoantiboby Evaluation

 In pernicious anemia, which of the following antibodies is characteristically detected?

anti-parital cell

Parietal cell antibodies are found in 90% of the cases with pernicious anemia.

Autoantiboby Evaluation

Anti-phospholipid antibodies associated with auto-immune disorders tend to have immunoglobulin (IgG)  that belongs to what subclass? 

Autoantiboby Evaluation

The IIF staining  pattern on ethanol-fixed leukocytes slides shows a perinuclear or nuclear staining pattern. this pattern is typically due to :

P-ANKA

C-ANKA shows a granular cytoplasmic staining pattern and P-ANKA shows a perinuclear or nuclear staining pattern

Autoantiboby Evaluation 

The specificity of an immunoassay is determined by the:

Autoantiboby Evaluation

In assesing the usefulness of a new laboratory test , sensitivity is defined as the  percentage of:

Autoantiboby Evaluation

In the indirect immunoflourescence method of antibody detection, the labeled antibody is:

Autoantiboby Evaluation

which of the following describes an antigen antibody reaction?

Autoantiboby Evaluation

The most common label in direct fluorescent antibody technique (DFA) is.

Autoantiboby Evaluation

A substrate is first exposed to a patients serum, then after washing , anti-human immunoglobulin labeled with a flurochrome is added, The procedure described is

Autoantiboby Evaluation

Avidity may be defined as the

Autoantiboby Evaluation 

In the interpretaton of agglutination test for fibrile disease, which of the following is of the greatest diagnostic importance?

rise in titer of the patients serum

A rising titer of antibody during the progression and resolution of an illness is an indication of infection with an organism.

Autoantiboby Evaluation 

Cholesterol is added to the antigen used in flocculation test for syphillus to

Autoantiboby Evaluation

the strength of the visable reaction is known as

Autoantiboby Evaluation 

what describes an antigen antibody precipitation reaction of non identity?

precipitation lines cross, forming double spurs

Each antigen forms an independant precipitation line with the cooresponding antobody at an equivalance point.

Autoantiboby Evaluation 

What test has the greatest sensitivity for antigen detection?

Autoantiboby Evaluation 

Excess antigen in precipitation gel reactons will:

dissolve the precipitate after formation

(no free antibody)

Autoantiboby Evaluation 

Soluable immune complexes are formed under the condition of:

antigen excess

as more antigen is added the reaction moves to antigen excess . Precipation does not occur due to lack of free antibody upon the addition of antigen a fixed quantity on antibody immune complexes start formng immediatly 

Autoantiboby Evaluation 

The visable serological reaction between soluable antigen and its specific antibody is

Autoantiboby Evaluation

The curve below was obtained by adding amounts of a soluable antigen to fixed volumes of monospecific antigens

the area on the curve for equlivance is

the center (top) of a bell curve

Autoantiboby Evaluation

The area on the curve where no precipitate formed due to antigen excess is:

Autoantiboby Evaluation

The area on the curve for prozone

the first 1/3

where the curve slowly builds

Autoantiboby Evaluation

the area on the curve where soluable antigen-antibody have begun to form is

Autoantiboby Evaluation

what area on the curve would more antibody result in the formation of additional precipitate is

Autoantiboby Evaluation

[image] 

which is the pattern that shows identity

Autoantiboby Evaluation

Which pattern shows non-identity?

Autoantiboby Evaluation

which pattern shows two different antigenic molecular species?

There is a  circle around the disc

Autoantiboby Evaluation

A non-specific precipitation pattern looks like

Autoantiboby Evaluation

A series of eight tubes are set up with 0.79 mL of diluent in each. A serial dilution is preformed by adding 10 um of serum to the fist tube then transferring 10 ul through each remaining tube.

What is the serum dilution of tube 7?

Autoantiboby Evaluation

The enzyme control tube in an ASO hemolytic assay exhibits no cell lysis. What is the most likely explanation for this?

Antibody identification

the following pattern of agglutination was observed in an antibody titration

1+ 2+ 4+ 4+ 3+ 3+ 2+ 1+ 1+ 0 0

This set of reactons most likely result from:

Autoantiboby Evaluation

In a positive anti-streptolysin O  enzyme inhibition test, the patients

Infectious disease serology

Blood is drawn from a patient for serological test for a viral disease at the time of onset and again 4 weeks later. The results of the test are considered diagnostic if the :

Infectious disease serology

What of the following is the most useful in establishing a diagnosis in the convalescence phase of a viral infection.

serological techniques

Infectious disease serology

The best method to detect infections due to rubella, Epstine barr, and human immunodeficicency viruses is

antibody detection by EIA

serological test are commonly used to detect antibodies in infectious with viruses that are difficult to culture such as rubella HIV and EBV

Infectious disease serology

immunoassays are based on the principle of

Infectious disease serology

A DPT vaccination is an example of

active humoral-mediated immunity

Vaccines stimulate host to produce antibody

Infectious disease serology

known to be actively phagocytic include

Infectious disease serology 

The presence of HbsAg, anti-HBc and often Hbe-Ag is characteristic of:

Infectious disease serology

Refer to the following data:

patient 1, HBsAg -, anti- HBc IgM -, anti-HaV IgM+

patient2 , HBsAg +, anti- HBc IgM +, anti-HaV IgM -

patient3 , HBsAg -, anti- HBc IgM +, anti-HaV IgM -

From the test results above, it can be concluded that patient 3 has:

acute hepatitis

the IgM anti-Hbc maybe the only arker during this phase.

remember that IgM is the first marker.

Infectious disease serology

The disappearance of HBsAg, the presistance of anti HBc, the appearance of anti-HBs, and often the anti-HBe indicate:

Infectious disease serology

an example of organ specific disease with autoimmune antibodies is:

Infectious disease serology

When testing a patient for HIV antibody, which of the following is used to confirm a positive screening test?

Infectious disease serology

An example of a live attenuated vaccine used for Human immunization is:

Infectious disease serology 

A cold agglutination titer end point is 1:16 after incubating overnight in the refrigerator and remains 1:16 after warming. The best corse of action is to:

test for antibody specificity

because the antibody is still reactive upon warming, a test for antibody specificity can help distinguish the pathological from the harmless

Infectious disease serology

What kind of antigen -antibody reacton would be expected if soluable antigen is added to homologous antibody.

Infectious disease serology

The rapid plasma reagin test:

Infectious disease serology 

flocculation test for syphillus detect the presence of

Infectious disease serology 

in the cold agglutinin test, the tube containing the serum and erythocytes are allowed to stand overnight in the refrigerator, and the results are read the next morning, If a disk of the erytherocytes floats up from the bottom the tube with only the flick of a finger, this is read as a:

4+ reaction

When 1 solid agglutinian is present the reaction is classified as 4+

Infectious disease serology

Flocculation test for syphillus use antigen composed of:

Infectious disease serology

The following cold agglutinine titer results are observed:

1:1 + at 4, - at 37

1:2 + at 4, - at 37

1:4 + at 4, - at 37

1:8 + at 4, - at 37

1:16 + at 4, - at 37

1:32 + at 4, - at 37

1:64 + at 4, - at 37

1:128 + at 4, - at 37

1:256 - at 4, - at 37

1:512 - at 4, - at 37

The best interpretation is

positive , 1:128

A cold agglutinin titer is read at the last dilution showing agglutination.

Infectious disease serology 

A VDRL serum sample is heat inactivated, then placed in the refrigerator for overnight storage. Before being tested the serum must be.

Infectious disease serology

Subsances that are antigenic only when coupled to a protein carrier are:

 Infectious disease serology

A Haptinic determinant will react with

Infectious disease serology 

A serology test for syphilis that depends upon the detection of cardolipin-lecithin antigen is:

Infectious disease serology

The most important use of a nontreponemal antibody (NTA) test alone is.

Evaluating the sucess of therapy

this test has a high rate of false positives but once diagnosis is established it can be used to monitor the sucess of therapy.

Infectious disease serology

In the direct flourescent antibody test for primary syphilis, spirochets are detected by addition of labeled antibody to? 

Infectious disease serology 

In the FTA-ABS test, the presence of a beaded pattern of flourescence along the treponeme indicates...

Infectious disease serology

The FTA-ABS test for the serological diagnosis os syphilis is:

likely to remain positive after adequate antibiotic therapy

FTS-ABS remains positive for life

Infectious disease serology

A 16 year old boy with infectious mononucleosis has a cold agglutinin titer of  1:1200. An important consideration of this antibodys clinical relevance is the:

Infectious disease serology 

What assay would confirm the immune status of the Hepatitis B virus?

Infectious disease serology 

The following procedure has been routeinly used for detection of Hepatitis B surface antigen (HbsAg) because of its high level of sensitivity :

Infectious disease serology

An indirect ELISA method designed to detect antibody to the rubella virus is patient serum , the conjugate used should be

Infectious disease serology 

A request is recieved in the laboratory for assistance in selecting the appropriate test(s) for detecting lyme disease. What test do you suggest?

Infectious disease serology 

A bacterial protein used to bind human immunoglobulin is:

staphylococcus protein A

protein A found in cell walls of S.aureus bacteria has a high affinity for the FC region of IgG  and can be used to bind IgG in some laboratory assays.

Infectious disease serology

Which of the following is the best indicator of an acute infection with Hepatitis A virus

Infectious disease serology

Biological false positive VDRL, reactions are frequently encountered in patients with:

Lupus erythematosis

Patients with autoimmune diseases produce antibody aginst cardiolipin.

Infectious disease serology

Which serological marker of HBV (hepatitis B virus) infection indicates recovery and immunity?

anti-HBs

B surface antibody

Infectious disease serology 

The profile that matches the typical test profile for chronic active hepatitis due to Hepatitis B virus is:

HBsAg +

IgM anti HBc -

anti-HBc +

anti-HBs -

Infectious disease serology

For diagnosis of late latent or tertiary syphilis , the most appropriate assay is:

FTA-ABS

FTS-ABS remains positive through-out the course of syphilis

Infectious disease serology

A 26 year old nurse developed fatigue, a low grade fever, polyarthrtis  and uticaria, Two months earlier she had cared for a patient with hepatitis. Which of the following findings are likely to be observed in this nurse? 

Infectious disease serology

The classic antibody response pattern following infection with Hepatits A is:

Infectious disease serology

 Locate the surface antigen

Locate the surface antigen

[image]

Infectious disease serology

Locate the component for E antigen

Infectious disease serology

[image]

Locate the core antigen

Infectious disease serology

[image]

locate the viral DNA

Infectious disease serology

The 20nm speres and filimentous structures of HBV are

Infectious disease serology

The enzyme linked immunosorbent assay (ELISA) technique for the detection of HBsAg:

Infectious disease serology

The antigen marker most closely associated with transmissibility of HBV infection is

HBeAg

present in serum during times of active replication

Infectious disease serology

Chronic carriers of HBV

Infectious disease serology

Hepatitis C differs from A because it:

Infectious disease serology

in the initial immune response following infection with rubella is the production of which classes of antibodies?

Infectious disease serology

A maternal serum rubella titer that is equal to or greater than 1:8 indicates:

Infectious disease serology

A false-negative cold agglutinin test may result if:

Infectious disease serology

Which of the following is a treponemal test?

Infectious disease serology

 The air temperture throughout the serology laboratory is 20-24*C. How will this affect VDRL and RPR test results?

Infectious disease serology

What laborotory technique is most frequently used to diagnose and follow the course of therapy of a patient  with secondary syphilis?

Infectious disease serology

A patient suspected of having toxoplasmosis has a specific IgG antibody titer of 1:64 upon initial testing . The titer of a second serum sample from the patient, taken 3 weeks later, was 1:256 these results are indicative of

a present infection.

four fold increase

Infectious disease serology

The most commonly used serological indicator of recent streptococcal infection is the antibody to:

Protein analysis

 Antibodies composed of IgG immunoglobulin:

Protein analysis

Measurement of serum levels of which of the following can serve as a screening test for multiple allergies.

 Protein analysis

Cells that are precursers of plasma cells and also produce immunoglobulins are:

Protein analysis 

IgM antibodies are frequently hemolytic because of:

Protein analysis

To which of the following classes do the antibdies that cause hemolytic disease of the newborn belong?

Protein analysis

It is important to note that when a infant is born, levels of specific antibody of the following class are used to indicate neonatal infection

Protein analysis

The immunoglobulin classes most commonly found on the surface of circulating B lymphocytes in the peripheral blood of normal persons are

IgM and IgD

IgM and IgD are the classes of antibody found on most circulating B cells

Protein analysis

Antibodies are produced by

Protein analysis

Antibody class and antibody subclass are determined by major physiochemical differences and antigenic variation found primarily in the

Protein analysis

The ratio of kappa to lambda light chain producing cells in normal individual is

Protein analysis

Which of the following immunoglobulin classes  is associated with a secreatory component (transport piece)?

Protein analysis

The immunoglobulin class typically found to be present in saliva , tears and other secreations is:

Protein analysis 

Treatment of IgG with Papain  results in how many fragments from each immunoglobulin molecule? 

Protein analysis

The immunoglobulin class associated with immediate hypersensitivity or atopic reactions is

Protein analysis

Which of the following immunoglobulins is the most effective at agglutination?

Protein analysis 

Polyclonal B cell activation

Protein analysis 

Antibodies to which of the following immunoglobulins is Known to have produced anaphylactic reactions following blood transfusions?

Protein analysis

The key structural difference that distinguishes immunoglobulin subclasses is  the

sequence of the constant regions

they are the reason the different classes have different biological functions

 Protein analysis

Immunoglobulin idiotypic diversity is best explained by the theory of

Protein analysis

Whic of the following are true statements about selective IgA deficiency?

Protein analysis

 Which class of immunoglobulin is thought to function as an antigenic receptor site on the surface of immune B lymphocytes?

Protein analysis

 The IgM molecule is a :

Protein analysis

 Which of the following immunoglobulins is present in the higest concentration in normal human serum?

Protein analysis

Which of the following staements about immunoglobulins is true.

Protein analysis

Membrane -bound immunoglobulins molecules:

Protein analysis

The area of the immunoglobulin molecule referred to as the hinge region is located between which domains?

Protein analysis

Antibody idiotype is dictated by the:

Protein analysis

Antibody allotype is determined by the:

Protein analysis

Which IgG subclass is most efficient at crossing the placenta

Protein analysis

The J chain is associated with which of the following immunoglobulins

Protein analysis

The assembly of the complement "membrane attack unit id initiated with the bindind of:

Protein analysis

Macrophages ar characterized by:

Protein analysis

Macrophage phagocytosis of bacteria is enhanced by which of the following

Protein analysis

Which of the following is most likely to activate the alternative pathway of complement activation?

Haptins

Haptins initiate the alternative pathway of complement

PProtein analysis

Which of the following is the larger residual split portion of C3

C3b

C3 breaks down to a small C3a, which floats away and is an anaphylatoxin, and the larger C3b, which lands on the target surface and becomes part of C5 convertase, is also a powerful opsonin.

Protein analysis

Which of the following activities is associated with C3b

Protein analysis

After a penicillin injection, a patient rapidly develops respiratory distress, vomoitng and hives. this reaction is primarily mediated by:

Protein analysis

Which of the following is the recognition unit in the classical complement pathway;

Protein analysis

In immunofixation electrophoresis

the antigen is electrophoresed

and the monospecific anti-sera is reacted with it.

Protein analysis

Which of the following is the membrane attack complex of complement activation?

Protein analysis

Which of the following releases histamine and other mediators from basophils?

Protein analysis

The complement component C3

Can be measured by immunoprecipitation reactions.

RID

Protein analysis

The serum hemolytic complement level (CH₅₀)

is a measurement of total complement activity

Protein analysis

A single reliable screening test for detecting neonatal infection in the absence of clinical signs is:

Protein analysis

Bence jones proteins are

Protein analysis

A patients serum IgG is measured by radial immunodiffusion (RID) was 40 mg/dL. Another laboratory reported IgA abesnt. A possible explanation for this descrepancy is that the:

protein analysis

Goat  anti human IgG heavy chain specific alkaline phosphatase conjugate is a:

Protein analysis

Humoral Antobodies are produced by which cells?

Protein analysis 

Initiation of the activation mechanism of the alternative complement pathway differs from that of the classical pathway in that

Protein analysis 

Which of the following is cleaved as a result of activation of the classic complement pathway

C4

C4 is split into C4a and C4b

Protein analysis

The complement associated only with the alternative pathway of complement activaton is

 Protein analysis

What complement component is a strong chemotactic factor as well as a strong anaphylatoxin

C5a

b is bound a floats away

Protein analysis

The C3b component of complement 

Protein analysis

Components of the complement system most likely to coat a cell are

Protein analysis

The serological Test that can be modified to selectively detect only specific IgM antibody in untreatred serum is

enyyme immunoassay

 enzymes are very specific

Protein analysis

A patients serum is being analyzed in a sandwich assay. This patient has recieved mouse monoclonal antibody therapy, and shows a false positive reaction in the sandwich assay which is due to:

Protein analysis

A monoclonal spike of IgM. Bence jones proteinuria, and bone pain are usually associated with:

Protein analysis

The hyperviscosity syndrome is most likely to be seen in monoclonal disease of which of the following immunoglobulin classes

IgM

Waldenstroms macroglobulinemia is a monoclonal gammopathy in which tumor cells are making antibody

IgM

Protein analysis

Patients suffering from Waldenstroms macroglobulinemia demonstrate excessvely increased concentrations of to which of the following

Protein analysis

Which of the following is the most common humoral immune deficiency disease?

Protein analysis

Which of the following is a true statement about brutons a gammaglobulinemia

Protein analysis

Immunodeficiency with thrombocytopenia and eczema is often referred to as:

Protein analysis

The autosomal recessive form of severe combined immunodifeciency disease is also referred to as

Protein analysis

In hybridoma technology, the desireable fused cell is the:

Protein analysis

Potent chemotactic activity is associated with which of the following components of the complement system.

C5a

C5a is a chemotaxin for neutrophils, basophils, mast cells and monocytes

Protein analysis

Heriditary angeoma is characterized by:

Protein analysis

Which of the following has been associated with patients who have homozygous C3 deficency?

Protein analysis

Heriditary deficency of early complement components (C1, C4 and C2) is associated with?

Protein analysis

Heriditary deficicency of late complement components (C5, C6, C7 or C8) can be associated with which of the following conditions?

Protein analysis

For several months a 31 year old woman has had migratory polyarthritis and a skin rash. Upon admission to the hospital, the following laboratory data were obtained.

leukocyte count        4.7 x 10³/uL

differential                        normal

serum hemolytic complement    <22

ANA:      positive in a homo pattern

Rheumatoid factor test:   negative

urinalysis: protein 1+ occasional RBCs

this patients test results are consistant with:

Protein analysis 

Infantile X-Linked agammaglobulinemia is referred to as:

Protein analysis

Combined immunodeficiency disease with loss of muscle coordination is referred to as:

Protein analysis

In skin test, a wheal and a flair development is indicative of :

Protein analysis

Which immunologic mechanism is usually involved in broncial asthma?

Protein analysis

Antihistamines like Benadryl

Protein analysis

Which of the following is used to detect allergen specific IgE:

RAST

(looking for alergen specific IgE)

Protein analysis

A child has severe hay fever. A total IgE measurement was performed by the Ouchterlony immunodiffusion method. No lines of precipitation appeared on the immunodiffusion plate. The most likely explanation is:

Cellular immunity and histocompatibility

Which test is used to evaluate the cellular immune system in a patient

Cellular immunity and histocompatibility

T-cells are incapable of

secretion of immunoglobulins

While T cells help B cells in the presence of antibody production, they are not capable of secreting immunoglobulins themselves. Immunoglobulins are produced only by B cells and plasma cells

Cellular immunity and histocompatibility

T-lymphocytes are incapable of functoning as:

Phagocytic cells

Phagocytosis is mediated by macrophages, not by lympohcytes.

Cellular immunity and histocompatibility

Nonspecific killing of tumor cells is carried out by

Natural Killer cells

Natural killer cells do not specifically bind to tumor antigens, as do T lymphocytes and antibodies, They can kill tumor cells without having had prior exposure to them.

Cellular immunity and histocompatibility

Tumor markers  found in circulation are most frequently measured by

immunoassays

immunoassays are highly sensitive and specific

Cellular immunity and histocompatibility

A patient with B cell deficiency will most likely exhibit

increased bacterial infections

Antibodies are important in defense aginst bacterial infections. Patients with B-cell deficiencies are unable to produce adequite amounts of antibodies, and therefore exhibit increased bacterial infections. Also, B-cells are not phagocytic and do not produce complement.

Increased parasitic infections

T cells and cell mediated immnuity are important in defense aginst intracellular pathogens such as viruses, fungi, and parasites. Patients with T cell deficiencies will therefore exhibit increased parasitic infections.

Cellular immunity and histocompatibility

Which of the following is an important cellular mediator of immune complex tissue injury?

neutrophil

The tissue damage resulting from type III hypersensitivity is caused by the deposition of immune complexes, which recruit nutrophils to the tissues. The neutrophils release their lysosomal enzymes, resulting in inflammation and damage to the surrounding tissues.

Cellular immunity and histocompatibility

Which of the following mediators is released during T-cell activation?

Cytokines

While B cells are involved in humoral immunity through the production of antibodies, T cells mediate their responses through the release of soluable proteins called cytokines.

Cellular immunity and histocompatibility

The HLA antibodies used in histocompatibility typing have been obtained from which of the following

multiparous women

Multiparous women, or those having multiple children, frequently produce antibodies to fetal HLA antigens, which are of paternal origin. The serum from these women has therefore been used as a source for the HLA antibodies that are employed in the complement-dependant cytotoxicity test to type HLA antigens.

Cellular immunity and histocompatibility

Which of the following terms describes a graft between genetically unidenticle individuals belonging to the same species?

allograft

An isograft is between genetically identicle individuals, a Xenograft is between individuals of different species, and an autograft is transplanted from 1 location to another in the same individual.

Cellular immunity and histocompatibility 

Incompatibility by which of the following procedures is an absolute contraindication to allotransplantation

Cellular immunity and histocompatibility

Which is a recognozed theory of the origin of auto-immunity

production of antibodies that cross react with tissue components

The theory of molecular mimicry states that antibodies produced aginst foreign antigens, such as certian microorganisms  can cross react with self antigens to produce auto immunity . 

Cellular immunity and histocompatibility

C3b and Fc receptors are present on:

B-lymphocytes and monocytes

They clear immune complexes

Cellular immunity and histocompatibility

T lymphocytes that posses the CD8 surface marker mediate which of the following T-cell functions?

Cytotoxic

Cytotoxic T cells, which are capable of destroying targets such as tumor cells and virus infected cells, bear the CD8 surface marker.

Cellular immunity and histocompatibility

Delayed hypersensitivity may be induced by

Contact sensitivity to inorganic chemicals

Contact dermititus is delayed hypersensitivity, it is due to T cells responses to enviromental chemicals.

Cellular immunity and histocompatibility

The most rapid immediate hypersesnistvity reaction is associated with

anaphylaxis

Anaphylactic, or type I hypersensitivity occurs very rapidly, usually within 30 mins after antigen exposure. While transfusion reaction and serum sickness are examples of immediate hypersensitivity reaction, they gennerally do not occur as rapidly. 

Cellular immunity and histocompatibility

The normal controls for a quantitative B lymphocyte assay should have a value of what percentage of total lymphocytes counted?

21%

Normal peripheral blood should contain 80% T lymphocytes and 20% B lymphocytes.

Cellular immunity and histocompatibility

an immunoflourescence test using reagent antibody directed against the CD3 surface marker would identify which of the following cell types in a sample of human peripherial blood

all mature T-lymphocytes

CD3 is a marker to identify T lymphocytes. It is present on the surface of all mature T cells, regardless of the T subset.

Cellular immunity and histocompatibility

Refer to the following results for peripheral blood sample

T-lymphocytes

patient #1   85%

patient# 2   23%

patient#3   51%

patient#4   82%

normal control    44% 

the data above indicates:

The normal control is too low and another sample should be selected

About 70-85% of perepheral blood lymphocytes should be T cells.

Cellular immunity and histocompatibility

Refer to the following flow cytometry data:

absolute WBC 8,930

total lymphocyte: 30%

B-lymphocytes: 40%

T-lymphocytes 58%

calculate the absolute count for B-lumphocytes

1,072

8,930 X .40 X .30

Cellular immunity and histocompatibility

A concentrate of lymphocyte can be prepared from peripheral blood by:

density gradient centrifugation

lymphocytes can be obtained by density gradiant centrafugation with Ficoll-Hypaque. the lymphocytes can be found in the layer that overlays the ficoll-hypaque layer.

Cellular immunity and histocompatibility

In flow cytometry, labeled cells

Cellular immunity and histocompatibility

A marked decrease in C4 lymphocytes and a decrease in the CD4/CD8 ratio:

is associated with a viral induced immunodeficiency

(HIV-AIDS)

refer to the following data from a peripheral blood sample;

total WBC 10.0X10³/uL

differential:

neutrophils 68%

lymphocytes 25% (40% T-cells)

monocytes 4%

eosinophils 2%

basophils 1%

The expected total number of T cells is:

10.0 X .25 X .40

1000

 Cellular immunity and histocompatibility

A peripherial blood total leukocyte count is 10.0 X10³/uL, The differential reveals 55% neutrophils, 2% eosinophils,40% lymphocytes and 3% monocytes. Assuming a lymphocyte recovery of 85%-95%, what is the expected number of T-cells in a normal individual?

10.0 X .40 x .63

63-84% of T cells is normal and 63 is the lower limit

2500

Cellular immunity and histocompatibility

In laser flow cytometry, applying a voltage potential to sample droplets as they stream past the light beam and using charged deflector plates results in

Cellular immunity and histocompatibility

What is the immunological method utilized in the flow cytometer

immunofluersence

flow cytometry is the underlying principle of cell sorting

Cellular immunity and histocompatibility

Given the following data :

WBC 5.0 X 10³/uL

lymphs  15%

CD4 8%

Calculate the CD4

consistant with a viral infection such as HIV

CD4 well below the normal range  50-60%

Cellular immunity and histocompatibility

Bone marrow transplant donors and their recipents must be matched for which antigen system

Cellular immunity and histocompatibility

A 28 year old man is seen by a physician because of several months of intermittent low back pain. The patient's symptoms are suggestive of ankylosing spondylitus. Which of the following laboratory stidies would support this diagnosis?

Positive HLA-B27 antigen test

More than 95% of patients with ankylosing spondylitis are positive for the HLA-B27 antigen: therefore a positive result for this test would support this diagnosis.

Cellular immunity and histocompatibility

Cells from a patient with Hairy cell leukemia have immunologic and functional features of

B-lymphocytes and monocytes

Hairy cell leukemia cells have surface markers such as CD19 and CD20, which are characteristic of B cells, and other markers, such as CD11c, which are found on monocytes. They also stain positive for tartrate resistant acid phosphatase, which is found in osteoclast and macrophages.

Cellular immunity and histocompatibility

Which T-cell malignancy may retain Helper activity with regard to immunoglobulin systhesis by B-cells 

Sezary cells

Sezary cells are cells that have the helper T cell phenotype. (CD3+, CD4+)

Cellular immunity and histocompatibility

A patients abnormal lymphocytes are positive for CD2 antigen, lack C3 receptors and are negative for surface immunoglobulins. This can be classified as a disorder of:

T-cells

CD2, CD3 are T-cells

surface immunoglobulins are B-cells

Cellular immunity and histocompatibility

HLA typing of a family yealds the following results:

LOCUS A          B  LOCUS

father     (8,12)                (17,22) 

mother   (7,12)                (13,27) 

On the basis of these, predict these genotypes the possibility of ankylosing spondylitus in this percentage of their children.      

50%

mother will give the B alleal 13 or 27 each time she gives birth.

B27is for ankleosing spondylitis

Cellular immunity and histocompatibility

HLA-B8 antigen has been assiciated with which of the following pairs of diseases?

Cellular immunity and histocompatibility

Which of the following is an inportant marker for the presence of immature B-cells in Patients with acute lymphocytic leukemia (ALL)

terminal deoxynucleotidyl transferase

TdT

TdT is an enzyme that adds nucleotides onto the 3` end of a DNA molecule. It is present in immature T cells and B cells, and is used to differentiate ALL from mature B-cell malignancies.