exam 2

Question 1

what is the best temperature range for cold agglutinatinins to react?

Answer 1

0-5C

Question 2

give 3 examples of infections that may cause cold agglutinins to develop

Answer 2

mycoplasma pneumoniae
infectious mononucleosis
primary atypical pneumonia

Question 3

explain desensitization

Answer 3

a hypersensitive animal that is given very small subcutaneous injection of Ag at closely spaced intervals may be able to tolerate an ordinarily shocking dose without severe rxc.

can be used clinically for pt. with intense allergic rxc to penicillin or horse antiserum

Question 4

briefly explain Graves’ disease

Answer 4

hyperthyroidism
increased T3 and T4
decreased/absent TSH
goiter, wt. loss, tachycardia

Question 5

explain what the reactions mean in hemagglutination inhibition test

Answer 5

negative for agglutination = there was agglutination

+ = no agglutination

Question 6

within which organ is it thought that potentially self-reactive lymphocytes are removed?

Answer 6

thymus

Question 7

the Nichols strain of T. pallidum is used in what type of testing?

Answer 7

FTA-ABS

Question 8

when do serum tests for syphilis usually become reactive?

Answer 8

week 1-3 following appearance of primary lesions

Question 9

in secondary syphilis what would the serological tests look like, result wise.

Answer 9

positive

Question 10

how long after treatment does the serological test become nonreactive in secondary syphilis?

Answer 10

12-18 months

Question 11

the secondary stage of syphilis occurs how many weeks after the appearance of the primary chancre?

Answer 11

6-8 weeks

Question 12

name three pharmacologically active mediators of anaphylaxis

Answer 12

ECFA
triptase
chimase
neutrophils
chemotaxis

Question 13

which of the following is true about the late latent stage of syphilis: it is highly contagious, usually noncontagious, not detectable by serological tests, or not communicable between mother and fetus?

Answer 13

usually noncontagious

Question 14

P24 is a viral antigen that is the first to be detected in which potentially deadly virus?

Answer 14

HIV

Question 15

name three means of transmission of the HIV virus

Answer 15

intimate sexual contact
contact with blood or bodily fluids
perinatally from infected mother to infant (transplacental)

Question 16

needles that dispense antigen for the VDRL test must be calibrated to deliver how much?

Answer 16

1/60 mL

Question 17

the VDRL needles- how often should they be QC’d

Answer 17

every new batch

Question 18

T. pallidum crosses the placenta in which week of gestation?

Answer 18

18

Question 19

what does the FTA-ABS test identify in the patient’s serum?

Answer 19

specific trepnonemal

Question 20

FTA-ABS; what does the fluorescein labeled antihuman globulin do for the purposes of interpreting this test?

Answer 20

makes Ag-Ab rxc visible

Question 21

in the direct fluorescent antibody test, the ____ is “labeled” with fluorescent dye

Answer 21

Ab

Question 22

the serum is inactivated to destroy complement in the VDRL or the RPR?

Answer 22

VDRL

Question 23

give 5 examples of an autoimmune disease and describe wether it is organ-specific and, if so, which organs are affected etc

Answer 23

hoshimotos thyroiditis- OS- thyroid gland
Graves disease- OS-thyroid gland
Rheumatoid Arthritis- OS- synovial lining of joints
Systemic Lupus Erythematosis-SYS- body tissues
Good Pasteurs Syndrome- OS- glomerulus

Question 24

a flat-bottomed bottle is required in the VDRL or the RPR?

Answer 24

VDRL

Question 25

explain a flocculation test and give examples of this type of testing

Answer 25

a very specific type of precipitation that occurs over a narrow range of Ag concentration ex. RPR

Question 26

the VDRL or the RPR is always read macroscopically?

Answer 26

RPR

Question 27

a modified VDRL antigen is used in what type of testing?

Answer 27

RPR

Question 28

name some synonyms for Type B viral hepatitis

Answer 28

Hepatitis B HBV serum hepatitis

Question 29

what is chancre?

Answer 29

lesions that occur in the peripheral region that occur in syphilis

Question 30

what speed should the rotator be set at for the RPR test

Answer 30

100 rpm

Question 31

what speed should the rotator be set for the VDRL

Answer 31

180 rpm

Question 32

why do you get false negative results with a postzone reaction?

Answer 32

because of the excess Ag present that may be obscuring a small amount of Ab

Question 33

the antibody to tissue lipids is called?

Answer 33

reagin

Question 34

why would you get a false negative results with a prozone reaction?

Answer 34

excess Ab over Ag

Question 35

explain the zone of equivalence

Answer 35

in the precipitation curve this is where the optimal proportions of Ab and Ag are reached stable lattice structures are formed and precipitate out, allowing visual

Question 36

what is tannic acid used for in serologic testing?

Answer 36

allows proteins to complex with RBC as antigen carriers

Question 37

what is serum sickness?

Answer 37

a benign and self limiting disease that results from passive sensitization with animal serum used to treat infections such as tetanus, diphtheria, and gangrene

Question 38

how does the Western Blot test differ from ELISA test?

Answer 38

ELISA- screening test that ID's Ab | WB- Ag for confirmatory testing

Question 39

what is an agglutinin?

Answer 39

``` the Ab involved in a agglutination reaction particulate Ag (such as cells) agglutinate with Ab ```

Question 40

why is cholesterol added to the antigen that is used in the flocculation test for syphilis?

Answer 40

because it provides absorption centers for the tissue lipids so agglutinated particles can be visualized

Question 41

T or F | treating a pregnant woman with syphilis does not cure the fetus

Answer 41

false

Question 42

T/F | congenital, primary, and secondary syphilis are best treated by repeated doses of penicillin

Answer 42

false

Question 43

T/F | treatment does not alter any tissue damage that has already occurred

Answer 43

true

Question 44

T/F | it is necessary to get repeated blood tests for 5 years following treatment

Answer 44

false

Question 45

T/F | tertiary syphilis cannot be treated

Answer 45

false

Question 46

loss of self tolerance results in what type of disease?

Answer 46

autoimmune

Question 47

explain cross reactivity and what kind of results it can lead to

Answer 47

Ag that are closely related in structure and get a false +

Question 48

the presence of anti-double stranded DNA can distinguish RA from what other autoimmune disease

Answer 48

lupus

Question 49

recent experience or exposure to group A hemolytic streptococci can be detected when there are high or steadily increasing concentrations of what in a patients serum?

Answer 49

antistreptolysin O

Question 50

define anaphylaxis

Answer 50

"without protection" most severe type of allergic reaction, involves multiple organs and may be fatal

Question 51

what is a xenograft? and what is it also known as?

Answer 51

heterograft | a transplant from one species to another species

Question 52

transplanting from one individual to a genetically nonidentical person of the same species is called what?

Answer 52

homograft or allograft

Question 53

define contact dermatitis

Answer 53

a delayed hypersensitivity reaction caused by T-cell sensitization to low molecular weight compounds that come in contact with the skin

Question 54

give three examples of contact dermatitis

Answer 54

nickel rubber poison plants (ivy, oak)

Question 55

which type of test is most widely used to detect HIV

Answer 55

ELISA

Question 56

of Hep C, Hep G, Hep B, which is the most virulent?

Answer 56

Hep C

Question 57

Why is Hep C more dangerous than Hep B?

Answer 57

85% of cases convert to chronic Hep. | 2 out of 3 patients become carriers who can transmit

Question 58

what is the first antigen to appear int he serum of a person infected with HBV?

Answer 58

hepatitis B surface antigen

Question 59

How is hepatitis A transmitted?

Answer 59

fecal-oral route

Question 60

Type IV hypersensitivity is the only type that involves what?

Answer 60

T-cells

Question 61

T/F | testing for the p24 antigen would be useful as a screening test for blood products?

Answer 61

false

Question 62

on average how long does it take (weeks) for an individual to develop HIV antibodies after exposure to HIV

Answer 62

6-12 weeks

Question 63

what antibody appears in the serum of individuals that have recovered from Hepatitis B or who have received the Hepatitis B vaccination?

Answer 63

Hepatitis B surface Ab AKA HBSAb anti-HBSAg

Question 64

which form of hepatitis is responsible for the most post-tranfusion reactions?

Answer 64

Hep C

Question 65

if a patient has an immune response to their own IgG, they would most likely to have a positive or negative RA test?

Answer 65

positive

Question 66

which set of antigens would be represented on a positive Western Blot?

Answer 66

Gp 41 | Gp 120

Question 67

The antigen in a precipitin reaction must be ?

Answer 67

soluble

Question 68

what does ANA stand for?

Answer 68

antinuclear antibody

Question 69

how is ANA useful in testing?

Answer 69

found in greater than 95% of lupus patients

Question 70

what does HLA stand for and why is it important?

Answer 70

human leukocyte antigen most important immunologic barrier for transplanted tissues

Question 71

which hepatitis virus requires HBV infection?

Answer 71

Hep D

Question 72

when discussing EBV and infectious mono, name the primary mode of transmission.

Answer 72

intimate contact with salivary glands

Question 73

what % of lymphs would you expect to see as a typical on a peripheral blood smear in EBV and infectious mono

Answer 73

10%

Question 74

which malignancy has been associated with EBV?

Answer 74

burkitt's lymphoma | hodgkins disease

Question 75

which virus have most people been exposed to by their elderly years?

Answer 75

cytomegalovirus (CMV)

Question 76

how do antiretroviral drug therapies work?

Answer 76

by blocking various steps in viral replication

Question 77

name some examples of antiretroviral drugs

Answer 77

fusion inhibitors integrase inhibitors core receptor antagonists

Question 78

which cells are the main target of HIV virus? why?

Answer 78

T-helper cells | b/c of CD4 Ag serves as a receptor for the virus by binding the Gp 120 glycoprotein on the outer envelope

Question 79

what is one method for determining the progression to the AIDS stage of HIV infection. how is this done?

Answer 79

CD4 count of < 200/ microliter flow cytometrey

Question 80

shingles is essentially a re-emergence of what virus?

Answer 80

varicella-zoster

Question 81

regarding HIV transmission, which specimens are not considered infectious unless visibly bloody?

Answer 81

``` saliva sputum nasal secretions tears sweat urine vomit and feces ```

Question 82

in the HIV virus what is reverse transcriptase responsible for doing?

Answer 82

responsible for conversion of viral RNA to complementary DNA

Question 83

Name the gene that codes for the enzymes necessary for HIV replication

Answer 83

pol gene

Question 84

briefly describe the latency period of HIV infection

Answer 84

decrease in viremia subtle/absent symptoms gradual deterioration of immune system

Question 85

what is the approximate length of time for the latency period in HIV infections?

Answer 85

10 years

Question 86

symptoms of primary infections of HIV are similar to symptoms from what other virus?

Answer 86

IM

Question 87

what are advantages of chemiluminescent assay

Answer 87

excellent sensitivity reagents are stable, relatively nontoxic inexpensive faster turn around time

Question 88

what are the disadvantages of chemiluminescent assay

Answer 88

false results possible from lack of precision in injection of the hydrogen peroxide urine and plasma may cause quenching of the light emission

Question 89

briefly describe the methodology of turbidimetry

Answer 89

measure of cloudiness of solution | measures reduction of light intensity due to reflection, absorption and scatter

Question 90

briefly describe nephlometry

Answer 90

measures the light that is scattered at a particular angle from the indecent beam as it passes through a suspension

Question 91

the antibody that is rheumatoid factor belongs to which Ig class?

Answer 91

IgM

Question 92

what is the test anti-CCP?

Answer 92

anti- cyclic citrillunated peptide

Question 93

what is the anti-CCP used for?

Answer 93

lead marker for RA

Question 94

precipitation

Answer 94

combining soluble Ag with soluble Ab to produce insoluble complexes that are visible