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Immunology & Serology > Final Exam Study Guide > Flashcards

Final Exam Study Guide Flashcards

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1
Q

Define Immunity

A

The ability of an organism to resist infection or disease by recognizing and responding to pathogens.

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2
Q

Define Phagocytosis and the cells involved

A

The process by which cells (e.g., neutrophils, monocytes/macrophages, and dendritic cells) engulf and digest pathogens and debris.

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3
Q

Define opsonization

A

The process of coating a pathogen with opsonins (like antibodies or complement proteins) to enhance its uptake by phagocytes

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4
Q

Define chemotaxis

A

The movement of cells (e.g., phagocytes) toward the site of infection in response to chemical signals.

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5
Q

Define CD markers

A

“Cluster of Differentiation” markers are cell surface proteins used to identify immune cell types and their stages (e.g., CD4 for helper T cells, CD8 for cytotoxic T cells).

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6
Q

Define Innate Immunity

A

Specific? No

Memory? No

Response time? Immediate

First line of defense, includes barriers and immune cells that respond to general threats.

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7
Q

List External Defenses of Innate Immune System

A

Skin, mucous membranes, tears, saliva, stomach acid.

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8
Q

List internal defenses of Innate Immune system and name the cells and their function

A

Neutrophils: Engulf pathogens

Macrophages: Phagocytosis & cytokine production

Eosinophils: Combat parasitic infections

Basophils/Mast cells: Release histamine, allergic responses

NK Cells: Kill virus-infected and tumor cells

Dendritic Cells: Antigen-presenting cells that initiate adaptive immunity

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9
Q

What triggers NK cells to phagocytize

A

Low or absent MHC I on target cells and presence of activating ligands

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10
Q

Define Adaptive immunity and what are the 2 branches

A

Specific? Yes

Memory? Yes

Response time? Delayed (days)

Two branches: Humoral and Cellular

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11
Q

Cellular immunity is made up of which cell; what is its CD marker; what is the function of cytotoxic and helper cells

A

Cells: T cells

CD markers: CD4 (Helper), CD8 (Cytotoxic)

Functions:

Helper T cells (CD4): Activate B cells, macrophages

Cytotoxic T cells (CD8): Kill infected cells

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12
Q

Humoral immunity is made up of which cell: what is its CD marker, what is its function

A

Cells: B cells

CD marker: CD19

Function: Produce antibodies to neutralize pathogens

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13
Q

What are Plasma cells (and their function)

A

Differentiated B cells that secrete large quantities of antibodies.

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14
Q

Function of Treg cells

A

Suppress immune responses to maintain self-tolerance and prevent autoimmune disease.

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15
Q

C-reactive protein (CRP)- one of the Acute phase reactants; has a role in opsonization; monitored in infection/inflammatory response

A

An acute-phase reactant; rises during inflammation; enhances opsonization.

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16
Q

What is the normal ratio of Th cells: T cytotoxic cells

A

Approximately 2:1 (CD4:CD8)

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17
Q

Where do T cells mature

A

Thymus.

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18
Q

Mature T cells possess which 2 CD markers

A

Either CD4 or CD8 (not both in mature cells).

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19
Q

What are APRS?

A

Proteins whose levels change in response to inflammation (e.g., CRP, fibrinogen, serum amyloid A).

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20
Q

Define antigen

A

Any substance that elicits an immune response, particularly the production of antibodies.

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21
Q

Define epitope

A

The specific part of an antigen recognized and bound by an antibody.

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22
Q

What are they made of? (Fab) (Fc) How many heavy chains? Light chains? (name of the light chains)

A

Fab (Fragment antigen-binding): Binds antigen

Fc (Fragment crystallizable): Interacts with immune cells

Heavy chains: 2

Light chains: 2 (types = kappa & lambda)

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23
Q

How many major classes of immunoglobulins and what are their classes based on?

A

IgG – gamma

IgA – alpha

IgM – mu

IgE – epsilon

IgD – delta

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24
Q

What are the functions of each of the 5 Ig classes and their structure

A

IgG: Most abundant; crosses placenta; opsonization; long-term immunity

IgA: Found in mucosal areas (secretions – tears, saliva, breast milk)

IgM: First responder; great at complement fixation; pentamer shape

IgE: Allergic reactions; binds mast cells/basophils; anti-parasitic

IgD: B cell receptor (function not well-defined)

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25
Know the antibody response curve; primary and secondary responses; What AB shows up first, second?
Primary response: IgM shows up first Secondary response: IgG dominates and appears faster (anamnestic)
26
Which Ig fixes complement best
IgM (due to pentameric structure)
27
Which Ig is the most abundant in the plasma
IgG
28
Which Ig can cross the placenta
IgG
29
Define isotype
Refers to the class of the antibody (e.g., IgG, IgA)
29
Define anamnestic response
A secondary immune response with faster and stronger antibody production due to memory cells.
30
Define idiotype
Unique antigen-binding site of an antibody.
31
What is the end-product of complement
Membrane Attack Complex (MAC) – causes cell lysis
32
What activates the classical complement pathway? What activates the alternative complement pathway
Triggered by antigen-antibody complexes (mostly IgG, IgM)
33
What does the recognition unit consists of in the classical complement pathway
Triggered by microbial surfaces, no antibody needed C1q, C1r, C1s
34
What does the membrane attack complex consists of
C5b, C6, C7, C8, C9
35
What is the function of C3b
Opsonization – tags pathogens for phagocytosis
36
What is the function of C5a
Chemotaxis – attracts phagocytes
37
What 2 minerals are required for the complement pathways
Calcium (Ca²⁺), Magnesium (Mg²⁺)
38
When C3 splits, what is the larger remaining portion
C3b is the larger portion (used for opsonization)
39
Syndrome associated with Decrease levels of C3, C1, C2, C4, C5, C6, C7, C8
C3 deficiency: Severe recurrent infections C1, C2, C4 deficiency: Lupus-like syndromes C5-C9 deficiency: Recurrent Neisseria infections
40
Complement pathway involves Factor, Factor B, and properdin
Involved in the Alternative Pathway
41
Complement pathway that involves Mannose binding lectins
Yes – it activates the Lectin pathway
42
How do you heat in-activate complement in serum
56°C for 30 minutes
43
Define titer
The highest dilution of a sample that still gives a positive test result. It reflects the concentration of antibodies in the serum.
44
Acute and Convalescent titers (When are they drawn and what is considered diagnostic results?)
Acute phase: Drawn during early symptoms Convalescent phase: Drawn 2–4 weeks later A 4-fold increase (e.g., 1:8 → 1:32) is diagnostic of recent infection.
45
Define precipitation
A reaction between soluble antigen and antibody forming an insoluble complex.
46
Define analytical sensitivity
The lowest concentration of a substance that can be detected by a test.
46
Define agglutination
A reaction where particulate antigens (like cells or beads) clump together with antibodies.
46
Know ouchterlony immunodiffusion reactions; Identity, Partial identity, and Non-identity
Identity: Smooth arc; same antigen Partial Identity: Spur formation; some shared epitopes Non-identity: X or crossed lines; no shared antigen
46
Cross-reactivity as a testing interference results in
Occurs when an antibody reacts with a similar but incorrect antigen, leading to false positives.
46
Know precipitation curve; prozone, post-zone, zone of equivalence and the definitions for all
Prozone: Excess antibody → false negative Post-zone: Excess antigen → false negative Zone of Equivalence: Optimal antigen-antibody ratio → visible precipitation
46
Define passive agglutination
Antigens are attached to particles (latex beads) to detect antibody (or vice versa).
46
define agglutination inhibition test
If antigen in the sample binds all the antibody, no agglutination occurs = positive result.
47
What is hemagglutination test
An agglutination reaction using red blood cells.
48
Define Affinity
Strength of binding between a single epitope and one antibody binding site.
49
Define avidity
The overall strength of binding between multiple antigen-antibody sites (sum of affinities).
50
What is the spirochete that cause syphilis
Treponema pallidum
51
Using dark-field microscopy to diagnose T. palludum what must be seen
Motile spirochetes with corkscrew motion
52
What are 2 non-treponemal test for T. pallidum; what type of test reaction are they
VDRL (Venereal Disease Research Lab) RPR (Rapid Plasma Reagin) → These are flocculation tests (non-specific)
53
What protein does the body produce as a result of infection with T. pallidum
Reagin antibody
54
What is the antibody that the non-treponemal tests for? What substance is this antibody directed against
Cardiolipin – a lipid from damaged host cells
55
What is the name of the antigen used in both the VDRL and RPR
Cardiolipin + cholesterol + lecithin (VDRL adds choline chloride)
56
RPR or VDRL: which needs to be heated 56 C for 30 min to inactivate complement? Which needs to be read microscopically
VDRL: Heated to 56°C for 30 mins; microscopically read RPR: No heating; macroscopically read
57
RPR test needs to rotate at what speed and how long?
100 rpm for 8 minutes
58
Which test is recommended for testing CSF for syphilis?
VDRL
59
FTA-ABS stands for what? What antibody does it test for?
→ Detects anti-treponemal antibodies
60
TP-PA stands for what? What antibody does it test for?
→ Detects antibodies to T. pallidum
61
Know 4 stages of syphilis and what clinical signs are associated with them.
Primary: Chancre (painless sore) Secondary: Rash (palms/soles), fever, lymphadenopathy Latent: No symptoms Tertiary: Gummas, neurological & cardiac symptoms
62
Treatment for syphilis
Penicillin G
63
What virus/bacteria causes: infectious mononucleosis, Rocky Mountain Spotted Fever, Oral Herpes, Genital Herpes, Shingles, chickenpox, AIDs, Adult T-cell leukemia, Measles, German Measles, Walking pneumonia (atypical pneumonia), Lyme disease, Graft vs. Host disease, Genital warts
Infectious Mononucleosis: Epstein-Barr Virus (EBV) Rocky Mountain Spotted Fever: Rickettsia rickettsii Oral/Genital Herpes: Herpes Simplex Virus (HSV-1 & HSV-2) Shingles/Chickenpox: Varicella-Zoster Virus (VZV) AIDS: HIV Adult T-cell Leukemia: HTLV-1 Measles: Rubeola virus German Measles: Rubella virus Walking pneumonia: Mycoplasma pneumoniae Lyme Disease: Borrelia burgdorferi Graft vs. Host Disease: Immune reaction post-transplant Genital warts: Human Papillomavirus (HPV
64
What does the MMRV vaccinate for
Measles Mumps Rubella Varicella (chickenpox)
65
Know the HBV scheme for Ag and AB (which show up first and so on)
HBsAg (Hepatitis B surface antigen) – first to appear = infection HBeAg – viral replication/high infectivity Anti-HBc (IgM) – recent infection Anti-HBe – decreasing infectivity Anti-HBs – recovery or immunity
66
What does positive anti – HBs indicate? What if patient is positive for anti-HBc, anti-HBe & anti-HBs
Recovery or vaccination = immunity Past infection and now immune
67
The presence of what HBV marker indicates infectivity?
HBeAg
68
Healthcare workers get vaccinated for what virus and what is used to make the vaccination
Hepatitis B → Vaccine made from HBsAg (surface antigen
69
What AG is routinely detected in the serum of HIV patients?
p24 antigen
70
What is the historically used confirmation test for positive screening HIV?
Western Blot (now replaced by newer tests)
71
What cells is greatly decreased in AIDs patients?
CD4+ T cells
72
How does the lab monitor the stage of HIV infection? What instrument is the gold standard for enumerating these cells?
CD4 count using flow cytometry (gold standard)
73
An HIV infected patient is in what stage of disease when they get reoccurring opportunistic infections? What stage when they have a CD4+ count <200?
AIDS stage – CD4 < 200 cells/µL
74
Ratio of Th cells : T-cytotoxic cells in AIDs patient?
Drops below 1:1 (normal is ~2:1)
75
Define autoantibody.
An antibody produced by the immune system that mistakenly targets the body’s own tissues.
76
Define Autoimmune disease.
A condition where the immune system attacks the body’s own cells and organs.
77
How many types of hypersensitivity are there? How are they different?
Type I (A) – Anaphylactic/Allergic (e.g., anaphylaxis, asthma) Type II (C) – Cytotoxic (e.g., HDN, autoimmune hemolytic anemia) Type III (I) – Immune complex (e.g., SLE, RA) Type IV (D) – Delayed (T-cell mediated, e.g., poison ivy, TB test)
78
A-C-I-D?
Type I (A) – Anaphylactic/Allergic (e.g., anaphylaxis, asthma) Type II (C) – Cytotoxic (e.g., HDN, autoimmune hemolytic anemia) Type III (I) – Immune complex (e.g., SLE, RA) Type IV (D) – Delayed (T-cell mediated, e.g., poison ivy, TB test)
79
What type of hypersensitivity is associated with each disease: SLE, Anaphylaxis, Poison Ivy, Asthma, RA, HDN?
SLE: Type III Anaphylaxis: Type I Poison Ivy: Type IV Asthma: Type I Rheumatoid Arthritis (RA): Type III Hemolytic Disease of the Newborn (HDN): Type II
80
Which 3 ANA patterns are associated with SLE?
Homogeneous Speckled Peripheral (Rim)
81
The 2 most common antibodies seen in SLE?
Anti-dsDNA Anti-Sm
82
Which auto-antibody goes with these clinical findings? Hypothyroidism, Hyperthyroidism, Anit-CCP & RF, Ab to acetylcholine receptors, Ab to myelin sheath nerves, Ab to salivary/tear ducts, AB to basement membranes, AB to the pancreas islet cells.
Hypothyroidism: Anti-TPO (thyroid peroxidase) Hyperthyroidism (Graves): TSI (thyroid-stimulating immunoglobulin) Rheumatoid Arthritis: Anti-CCP & Rheumatoid Factor (RF) Myasthenia Gravis: Anti-acetylcholine receptor Multiple Sclerosis: Anti-myelin sheath Sjögren's Syndrome: Anti-SSA/Ro, Anti-SSB/La Goodpasture’s Syndrome: Anti-GBM (glomerular basement membrane) Type 1 Diabetes: Anti-islet cell antibodies
83
Patients with Rheumatoid arthritis form an antibody directed against the Fc portion of IgG antibodies called
Fc portion of IgG → Rheumatoid Factor (RF)
84
This disease is characterized by a hyper viscosity and a monoclonal IgM production
Waldenström’s Macroglobulinemia
85
This disease has symptoms characterized by the acronym C.R.A.B. (which stand for what
Multiple Myeloma C: HyperCalcemia R: Renal failure A: Anemia B: Bone lesions
86
What CD markers are associated with Multiple myeloma and Waldenström’s macroglobulinemia
CD38+, CD138+ (plasma cells) B-cell markers: CD19+, CD20+ in Waldenström
87
Dilution equations: Solve for the solute (patient sample); Solve for the solvent (diluent) Total dilution (solute + solvent = Total volume expressed a ratio)
Total Dilution = Solute : (Solute + Diluent) → Example: 1 part serum + 9 parts saline = 1:10 dilution To solve for Solute: Solute = Total Volume × (Dilution Factor) To solve for Diluent: Diluent = Total Volume − Solute Example: You need 10 mL of a 1:5 dilution. → Solute = 10 × (1/5) = 2 mL → Diluent = 10 − 2 = 8 mL

Immunology & Serology (7 decks)

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