Flashcards in Ch. 8 Specific Diagnostic Modalities Deck (67):
polymorphism in which chemokine are associated with serum total IgE?
CCL-11 (eotaxin) - increased in blacks, decreased in whites
venom IDTs are performed up to what concentration?
nasal responsiveness to capsaicin is increased in what condition?
allergic rhinitis (not in non-allergic)
both histamine and methacholine induce a secretory response, but unlike histamine, methacholine does not induce?
what is the most reproducible measurement in pulmonary function test?
what is the primary outcome measure in most FDA phase III asthma drug trials?
what is considered a significant response to bronchodilator?
increase of FEV1 of 12% AND increase of 200mL
T or F, severity of airway hyper responsiveness does not correlate with severity of asthma
what is the difference between selective and non-selective bronchoprovacation?
selective testing looks at specific triggers, non selective testing produces bronchoconstriction in all asthmatic
is methacholine a direct or indirect bronchonconstrictor?
what PC20 concentration is considered positive?
PC20 < or equal to 8mg/ml
T or F, a negative methacholine challenge in the winter excludes seasonal pollen induced asthma?
what are the indirect bronchoconstrictors?
exercise, hypertonic saline, cold, mannitol, adenosine, allergen
which bronchoprovocation test is highly sensitive? specific?
specific: mannitol, exercise
mucus is increased in asthmatic, which gene is expressed more in asthmatics compared to normal controls?
mucin gene (MUC5AC)
who gets more airway infections, primary ciliary dyskinesia patients or CF?
CF - suggests that altered mucus plays larger role in disease progression than ciliary movement
what method is used to quantify IgG, IgA, IgM, and inflammatory markers?
what method to determine the presence of allergen specific IgE, BNP, complement, toxins, histamine, leukotriene C4, and tumor markers?
western blot procedure?
separate proteins on gel, transfer to a membrane, then add specific antibody followed by a secondary antibody conjugated to an enzyme, measure the colorimetric reaction
What diseases are confirmed by Western blot?
HIV and Hep B
what is the process of immunofixation electrophoresis
separate serum proteins on gel, expose to specific anti-sera and the immunoprecipitate is visualized with a protein stain
immunoCAP uses what method to detect allergen specific IgE?
ELISA -- sandwich assay
allergen IgE determined from Immunocap, Turbo MP and Immulite 200 are NOT comparable. Studies determining predictive values of specific IgE for food is determined by which one?
immunofixation electrophoresis is used for?
identification and quantification of monoclonal paraproteins seen on SPEP, and determine which light chain is present
zone of equivalence results in small or large immune complexes?
zone of antigen excess or antibody excess produces small or large immune complexes?
descending order of complement activation by immunoglobulin?
IgM > IgG3 > IgG1 > IgG2
excessive immune complex formation results in complement consumption, so what levels can be used to monitor disease activity?
C3, C4 (e.g. in SLE)
what assays are used to measure cytokines and mediators?
ELISA or RIA assays
forward scatter on flow cytometry measures?
side scatter on flow cytometr measures?
granularity and complexity
what monoclonal antibody is used in the treatment of solid organ transplant rejection and acute T cell ALL?
OKT3 - monoclonal anti-CD3
leads to activation then apoptosis of T cells causing immunosuppression
what is the proposed mechanism of IVIG?
binding of FcyRIIb
increased number of B cells with low levels of this CD marker are associated with CVID?
high levels of CD-21 low B cells
what CD markers are measured after an abnormal newborn screen for TRECs?
CD45RO and CD45RA, there are low levels of CD45RA in SCID
CD4 expression is down regulated by which HIV protein?
HIV binds to what CD marker as a correceptor for entry into T cells?
where does omalizumab bind on free IgE?
CH3 domain of free IgE, specifically at the FcERI binding site
what is the most potent complement receptor?
CR3 which binds iC3b
hereditary C3 deficiency presents with?
autoimmune disease and recurrent infections
which chemokine receptors are co-receptors for HIV entry?
how does the DHR test work?
DHR is taken up by phagocytes and oxidized to a green fluorescent compound by products of the NADPH oxidase system, fluorescence is measured by flow cytometry
AH50 measures lysis of alternative pathway by lysing what RBCs?
unsensitized rabbit RBCs
CH50 measures lysis of complement pathway by lysing what RBCs?
sheep RBCs sensitized with rabbit IgM
the most common cause of low complement level?
poorly handled specimen, always repeat abnormal test
hybridomas are made of what two cells?
spleen cells from an immunized mouse fused with myeloma cells that lack Ab production and HGPRT
chimeric -mouse and human
what method should be used in patients with antibody deficiencies to detect infections?
Besides SCID, what other conditions can have low TREC levels in newborns?
HIV, Down syndrome, and 22q11 deletion
what can nex-gen sequencing be used for?
whole exome sequencing, screening panels of disease-related genes, transcription factor binding sites, DNA methylation patterns, and metagenomics (studies microbial DNA populations)
southern blot detects?
western blot detects?
northern blot detects?
what can be diagnosed using FISH
22q11.2 deletion, Prader Willi, Angelman, Cri--du-chat, Down syndrome, ALL
microarray use what substrate and rely on what luminescence for detection?
substrate: glass, silicone, or polystyrene beads
use fluorescence for detection
microarrays can be used to detect?
gene expression patterns, SNPs, chromosomal abnormalities, genotype mutations
how do microarrays work?
known cDNA probes are present on microarray chip, RNA from patient is reverse transcribed to cDNA, which is amplified by PCR and labeled, the cDNA then hybridizes to microarray cDNA probes and the intensity of the fluorescence is measured to determine gene expression
what alleles are matched for SCT?
HLA-A, B, C, DRB1, and DQB1
what alleles are matched for solid organ?
HLA-A, B, DR
what solid organs are usually NOT matched for HLA type?
heart, liver, lung and pancreatic grafts
xray and CT finding in chronic eosinophilic pneumonia?
"photonegative" pulmonary edema
peripheral, non segmental opacities in middle and upper lung zones
CT findings in GPA?
peripheral wedge shaped consolidations, multiple nodules, some with cavitation
a pneumatocele on CT should make you think of what condition?
STAT 3 hyper IgE syndrome