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Immunology and Transfusion Medicine
MPA 515 Clinical Skills Module 1
100
Medical
Graduate
05/20/2009

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Cards

Term
What are the three major division of the immune system?
Definition
1. Humoral immunity (Ag-Ab)
2. Cell mediated immunity
3. Complement and its cascade of activation
Term
Which type of immunity involves (Ag-Ab) response and plasma circulating immunoglobulins (Ab)?
Definition
Humoral immunity
Term
What type of humoral immunity produces the Ab's IgM, IgG, IgA, IgE and IgD?
Definition
B cell line generated (lymphocyte) humoral immunity
Term
What type of immunology involves lymphocytes' response to foreign Ag and involves multiple subsets of lymphocytes?
Definition
Cell mediated immunity
Term
What are the three types of T lymphocytes?
Definition
T-helper cells
T-suppressor cells
Cytotoxic T cells
Term
What division of immunology involves plasma proteins activated by Ab attaching to surface of invading microbes?
Definition
Complement
Term
What can complement and its complexes attack?
Definition
Invading microbes
Term
How many pathways of action does the complement system have?
Definition
2
Term
"refers to a type of test that looks for non-specific antibodies in the blood of the patient that may indicate that the organism (Treponema pallidum) that causes syphilis is present. The term "reagin" means that this test does not look for antibodies against the actual bacterium, but rather for antibodies against substances released by cells when they are damaged by T. pallidum." -wikipedia
Definition
RPR- Rapid plasma reagin- screening test
Term
What are 6 types of immunological diagnostic testing?
Definition
Enzyme immunoassays (EIA)
Immunofluorescence
Particle agglutination/agglutination inhibition
Radioimmunoassay (RIA)
Complement fixation
Immunoelectrophoresis (IEP)
Term
What are 2 types of immunofluorescence?
Definition
Indirect fluorescent Ab (IFA)
Direct fluorescent Ab (DFA)
Term
What are 5 clinical utilizations of immunological dx testing?
Definition
Dx of infectious diseases
Dx of autoimmune disease
Monitor disease prevention (vaccination)
Allergy testing
Organ transplantation
Term
What are 6 common immunological studies?
Definition
Rapid plasma reagin (RPR)
Fluorescent treponemal Ab-absorbed double stain (FTA-ABS DS)
AutoAb
Allergy testing
Lymphocyte surface markers
Lyme (EIA or IFA)
Term
What are 2 common autoAb immunological studies?
Definition
Antinuclear Ab (ANA)
Anticardiolipin Ab (ACA)
(ex: Antiphospholipid Ab test)
Term
What is a type of common allergy testing immunological studies?
Definition
Radioallergosorbent test (RAST)
(ex: Allergy specific IgE assay)
Term
What are 2 common lymphocyte surface marker immunologic studies?
Definition
CD4, CD8, CD2, CD19
Histocompatibility Ag, like Human leukocyte Ag (HLA)
Term
What is an example of ACA?
Definition
Antiphospholipid Ab test is an example of Anticardiolipn Ab (ACA)
Term
What is an example of an RAST?
Definition
Allergy specific IgE assay is an example of a radioallergosorbent test (RAST)
Term
What is an example of a histocompatibility Ag?
Definition
Human leukocyte Ag (HLA)
Term
What is the pathology of RA?
Definition
Rheumatoid Arthritis (RA) is an autoimmune disorder involving Abs directed against IgG, that forms immune complexes (IgG-IgM) [igG RA igM- GRAM]
Term
What is a test utilized for dx and monitoring RA?
Definition
Rheumatoid factor tests for Rheumatoid arthritis (RA)
Term
Do low titers exclude RA?
Definition
Lower titers do not exclude rheumatoid arthritis
Term
On what are positive rheumatoid factor results based?
Definition
Positive results are based upon titers along with clinical history and clinically defined criteria
Term
False positive rheumatoid factor results are noted in what conditions?
Definition
False positive results are noted in other autoimmune disorders like SLE and Sjögren's syndrome, in elderly pts, and recently immunized pts
Term
CRP tests which phase?
Definition
Acute phase rxn protein
Term
What does a high CRP indicate?
Definition
inflammatory illness
Term
How specific is CRP?
Definition
nonspecific test
Term
In what organ is CRP produced?
Definition
liver
Term
CRP interacts with what
Definition
complement system
Term
Which is more sensitive: CRP or ESR?
Definition
CRP is more sensitive than ESR
Term
What is indicated in multiple inflammatory processes such as:
Coronary artery injury/disease
Bacterial infection
Tissue necrosis
RA (and other autoimmune disorders)
Wound infections
Definition
CRP
Term
Levels decrease with tx, resolution, or suppression of inflammatory disorders
Definition
CRP
Term
What test involves falsely increased levels with drugs, smoking and body habitus?
Definition
CRP
Term
What is dx for SLE?
Definition
ANA- Antinuclear Ab
Term
Does a negative ANA diagnose or exclude SLE?
Definition
Negative result excludes SLE
Term
What is ANA diagnostic for besides SLE?
Definition
other autoimmune disorders
Term
What test involves diagnostic results with titer and any of the four patterns:
diffuse
peripheral
speckled
nucleolar?
Definition
ANA
Term
What tests complement activity?
Definition
Serum complement
Term
Anti-Smith and anti-scleroderma-70 are what type of tests?
Definition
Additional ANA tests for more specific autoimmune disorders
Term
What is defined as the removal of specific blood components and returning remaining components to donor; blood product usually noted as "single donor"?
Definition
Apheresis
Term
What is defined as the process of transferring blood products from one person's circulatory system to another's?
Definition
transfusion
Term
What involves an autoAb disease directed against RBCs that acctivates complement cascade and damages cells?
Definition
cold Agg- active at lower temperatures
Term
What involves autoAb disease that involve IgG; pts may present with hemolytic anemia?
Definition
warm autoAb- autoAb disease more active at 37degreesC
Term
What is also known as blood bank?
Definition
transfusion medicine
Term
What is highly regulated by the FDA, AABB, ARC, and state?
Definition
immunohematology
Term
what processes and distributes blood products adn involves compatibility and cross-match testing?
Definition
Immunohematology- Transfusion medicine
Term
Who may donate blood?
Definition
individuals who meet eligibility criteria
Term
What are 3 tests done for blood donor units?
Definition
ABO AND Rh typing
Ab screening
Screening tests for donor infection
Term
What are 4 screening tests for donor infection?
Definition
Hep B and C
HIV/HTLV testing
Syphilis
West Nile Viris
Term
What are 3 clinical indications of blood transfusion?
Definition
Life threatening (surgery and trauma)
Anemia
Exchange transfusion
Term
Blood groups are defined by molecules found where?
Definition
molecules found on RBC
Term
Which blood typing system is most significant?
Definition
ABO
Term
What is also known as D Ag?
Definition
Rhesus blood group
Term
What is exemplified by Kell, Duffy, Lewis, and MNS plus others?
Definition
27 additional recognized blood group systems- minor system
Term
What are 4 indications for blood typing?
Definition
blood donation
blood recipient
screening; preoperative
blood typing of expectant mothers/neonate
Term
What aspect of transfusion medicine involves 4 major groups of naturally occuring Ags with genetic distribution?
Definition
ABO system
Term
How does sensitization to Rh antigens occur?
Definition
via pregnancy:
Rh (-) mother acted on by Rh (+) fetus
Maternal anti Rh (+) IgG antibodies affect fetus in future pregnancies
Sensitization may also occur via blood transfusion
prevention = early prenatal care
Term
What blood type is called a universal donor?
Definition
O
Term
What blood type is called a universal recipient?
Definition
AB
Term
Is compatibility the same with blood and plasma transfusion?
Definition
compatibility different from plasma transfusion
Term
What involves Type and Rh,
Type and Screen
Type and crossmatch
Blood compatibility testing, and
Indirect/Direct Coomb's (indirect/direct Ab test)
Definition
Blood bank testing
Term
What test determines ABO type and Rh status?
Definition
clinical lab Agglutination of serum or plasma
Term
When are type and Rh tests indicated?
Definition
newborns
blood donation
type specific uncross-matched blood tranfusion
Term
What screens for and ID's unexpected RBC alloAbs?
Definition
ABO type and Rh testing
Term
What type of tests are exemplified by the following?:
Direct Coomb's test
Test of lysis of RBCs
Pt's RBCs against prepared serum
Definition
Direct Ab testing
Term
In what test are RBCs washed prior to testing?
Definition
Direct Ab testing
Term
What are 2 indications for Direct Ab testing?
Definition
transfusion rxns
hemolytic disease of the newborn
Term
What type of tests are exemplified by the following:
Indirect Coomb's
Test to detect Ab's against RBCs
Definition
Indirect Ab testing
Term
When are Indirect Ab tests indicated?
Definition
screening portion of "type and screen"
detect cold Agg
Detect autoAb's
Term
What type of testing is necessary for blood component therapy?
Definition
pre-transfusion testing
Term
For what must recipients of blood component therapy be screened?
Definition
autoAb's
Term
Whole blood
packed RBC's
Fresh frozen plasma
cryoprecipitat
platelets
leukocyte concentrates
RhoGAM
Albumin
Purified factors
all exemplify what?
Definition
Blood products
Term
What involves 3% of recipient's HCT per unit transfused?
Definition
Packed RBC's?
Term
When are packed RBCs indicated?
Definition
symptomatic anemia
Term
What involves plasma (volume) and all coagulation factors?
Definition
fresh frozen plasma
Term
What involves a 20-30% increase in recipient's coagulation factor activity per unit?
Definition
fresh frozen plasma
Term
When is fresh frozen plasma indicated?
Definition
coagulation disorders
massive transfusion
Term
Is ABO compatibility required for fresh frozen plasma?
Definition
ABO compatibility required
Term
Should plasma be type specific?
Definition
type specific if possible
Term
When can group AB plasma be used?
Definition
For all groups in an emergency
Term
When can group AB plasma be used?
Definition
For all groups in an emergency
Term
When can o plasma be used?
Definition
resrict group o recipients - o plasma
Term
Does apheresis involve single or multiple donors?
Definition
single donor
Term
What are leukopoors?
Definition
washed blood products
Term
When should CMV negative blood products be used?
Definition
CMV negative- donor is CMV negative
Term
When should irradiated blood products be used?
Definition
irradiated- radiated product for viral inactivation
Term
What are exemplified by
Hemolytic rxns
allergic rxns
febrile rxns
bacterial contamination
circulatory overload
Transfusion related acute lung injury (TRALI)
Definition
transfusion rxns
Term
Which Ig appears first?
Definition
IgM is IMmediate
Term
Which Ig is passed from mother to child?
Definition
IgG passes during Gestation
Term
4 confirmatory tests of various chemical urine analytes?
Definition
1. ketones/acetace tests detects.
2. sulfosalicylic A test (SSA)- protein confirmatory test.
3. ClinaTest (reducing sugars).
4. ICTOTest (bilirubin).
Term
the standard treponemal antigen serologic test for syphilis, demonstrates specific treponemal antibodies in patient serum.
Definition
fta-abs ds, fluorescent treponemal Ab-absorbed 2x stain- confirmatory test
Term
ordered to help screen for autoimmune disorders and is most often used as one of the tests to diagnose systemic lupus erythematosus (SLE)
Definition
ana
Term
associated with SLE and mixed connective tissue disease
Definition
diffuse ana
Term
associated with SLE, Sjogren’s syndrome, scleroderma, polymyositis, rheumatoid arthritis, and mixed connective tissue disease
Definition
speckled ana
Term
associated with scleroderma and polymyositis
Definition
nucleolar
Term
associated with SLE
Definition
peripheral
Term
these crystals you should never see
Definition
cystine tyrosine lucine crystals- liver failure
Term
triple phosphate, calcium oxate crystals look like
Definition
coffins, envelopes
Term
artifact
Definition
contamination
Term
wet prep/wet mount
Definition
vaginitis test
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