Ch. 8 Specific Diagnostic Modalities Flashcards Preview

ACAAI Review 3rd Edition > Ch. 8 Specific Diagnostic Modalities > Flashcards

Flashcards in Ch. 8 Specific Diagnostic Modalities Deck (67):
1

polymorphism in which chemokine are associated with serum total IgE?

CCL-11 (eotaxin) - increased in blacks, decreased in whites

2

venom IDTs are performed up to what concentration?

1 ug/mL

3

nasal responsiveness to capsaicin is increased in what condition?

allergic rhinitis (not in non-allergic)

4

both histamine and methacholine induce a secretory response, but unlike histamine, methacholine does not induce?

nasal reflexes

5

what is the most reproducible measurement in pulmonary function test?

FEV1

6

what is the primary outcome measure in most FDA phase III asthma drug trials?

FEV1

7

what is considered a significant response to bronchodilator?

increase of FEV1 of 12% AND increase of 200mL

8

T or F, severity of airway hyper responsiveness does not correlate with severity of asthma

TRUE

9

what is the difference between selective and non-selective bronchoprovacation?

selective testing looks at specific triggers, non selective testing produces bronchoconstriction in all asthmatic

10

is methacholine a direct or indirect bronchonconstrictor?

direct

11

what PC20 concentration is considered positive?

PC20 < or equal to 8mg/ml

12

T or F, a negative methacholine challenge in the winter excludes seasonal pollen induced asthma?

FALSE

13

what are the indirect bronchoconstrictors?

exercise, hypertonic saline, cold, mannitol, adenosine, allergen

14

which bronchoprovocation test is highly sensitive? specific?

sensitive: methacholine
specific: mannitol, exercise

15

mucus is increased in asthmatic, which gene is expressed more in asthmatics compared to normal controls?

mucin gene (MUC5AC)

16

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

17

what method is used to quantify IgG, IgA, IgM, and inflammatory markers?

nephelometry

18

what method to determine the presence of allergen specific IgE, BNP, complement, toxins, histamine, leukotriene C4, and tumor markers?

ELISA

19

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

20

What diseases are confirmed by Western blot?

HIV and Hep B

21

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

22

immunoCAP uses what method to detect allergen specific IgE?

ELISA -- sandwich assay

23

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?

immunocap

24

immunofixation electrophoresis is used for?

identification and quantification of monoclonal paraproteins seen on SPEP, and determine which light chain is present

25

zone of equivalence results in small or large immune complexes?

large

26

zone of antigen excess or antibody excess produces small or large immune complexes?

small

27

descending order of complement activation by immunoglobulin?

IgM > IgG3 > IgG1 > IgG2

28

excessive immune complex formation results in complement consumption, so what levels can be used to monitor disease activity?

C3, C4 (e.g. in SLE)

29

what assays are used to measure cytokines and mediators?

ELISA or RIA assays

30

forward scatter on flow cytometry measures?

size

31

side scatter on flow cytometr measures?

granularity and complexity

32

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

33

what is the proposed mechanism of IVIG?

binding of FcyRIIb

34

increased number of B cells with low levels of this CD marker are associated with CVID?

high levels of CD-21 low B cells

35

what CD markers are measured after an abnormal newborn screen for TRECs?

CD45RO and CD45RA, there are low levels of CD45RA in SCID

36

CD4 expression is down regulated by which HIV protein?

Nef

37

HIV binds to what CD marker as a correceptor for entry into T cells?

CD4

38

where does omalizumab bind on free IgE?

CH3 domain of free IgE, specifically at the FcERI binding site

39

what is the most potent complement receptor?

CR3 which binds iC3b

40

hereditary C3 deficiency presents with?

autoimmune disease and recurrent infections

41

which chemokine receptors are co-receptors for HIV entry?

CCR5, CXCR4

42

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

43

AH50 measures lysis of alternative pathway by lysing what RBCs?

unsensitized rabbit RBCs

44

CH50 measures lysis of complement pathway by lysing what RBCs?

sheep RBCs sensitized with rabbit IgM

45

the most common cause of low complement level?

poorly handled specimen, always repeat abnormal test

46

hybridomas are made of what two cells?

spleen cells from an immunized mouse fused with myeloma cells that lack Ab production and HGPRT

47

ximab means?

chimeric -mouse and human

48

umab

human

49

zumab

humanized

50

omab

mouse

51

what method should be used in patients with antibody deficiencies to detect infections?

PCR

52

Besides SCID, what other conditions can have low TREC levels in newborns?

HIV, Down syndrome, and 22q11 deletion

53

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)

54

southern blot detects?

DNA

55

western blot detects?

protein

56

northern blot detects?

RNA

57

what can be diagnosed using FISH

22q11.2 deletion, Prader Willi, Angelman, Cri--du-chat, Down syndrome, ALL

58

microarray use what substrate and rely on what luminescence for detection?

substrate: glass, silicone, or polystyrene beads
use fluorescence for detection

59

microarrays can be used to detect?

gene expression patterns, SNPs, chromosomal abnormalities, genotype mutations

60

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

61

what alleles are matched for SCT?

HLA-A, B, C, DRB1, and DQB1

62

what alleles are matched for solid organ?

HLA-A, B, DR

63

what solid organs are usually NOT matched for HLA type?

heart, liver, lung and pancreatic grafts

64

xray and CT finding in chronic eosinophilic pneumonia?

"photonegative" pulmonary edema
peripheral, non segmental opacities in middle and upper lung zones

65

CT findings in GPA?

peripheral wedge shaped consolidations, multiple nodules, some with cavitation

66

a pneumatocele on CT should make you think of what condition?

STAT 3 hyper IgE syndrome

67

absent thymic shadow indicates?

complete Digeorge