Immunodiagnostics 1

Question 1

Simple Immunodiagnostic Tests

Answer 1

Full blood count and protein electrophoresis

Question 2

Specialised Immunodiagnostic tests

Answer 2

Immunoassays, immunofluorescence and immunophenotyping

Question 3

Immunodiagnostics Function

Answer 3

Diagnosis, treatment monitoring and monitoring patient response (need to increase/decrease immune response)

Question 4

Infection def

Answer 4

Inability to clear infection (active symptoms). Indicated by elevated immune cells (particularly neutrophils)

Question 5

Primary Immunodeficiency Def

Answer 5

Genetically lacking a component of our immune system

Question 6

Secondary Immunodeficiency Def

Answer 6

Losing a component of our immune system due to factors in our environment. Eg immunosuppressant drugs

Question 7

Malignancy Def

Answer 7

Over proliferation of a cell. Mainly effects: t cells, B cells, macrophages, dendritic cells and mast cells

Question 8

Autoimmunity Def

Answer 8

Immune attack against our own bodies. Increased antibody production against self peptides

Question 9

Allergy/hypersensitivity Def

Answer 9

overreaction of our immune system to a non-infectious agent. Increased antibodies agaisnt allergen

Question 10

Disorders of the immune system

Answer 10

infection, hypersensitivity, autoimmunity, immunodeficiency and malignancy

Question 11

Examples of samples collected

Answer 11

Blood, urine, cerebral spinal fluid, bone marrow aspiration and biopsy

Question 12

Full Blood Count Outline

Answer 12

1st line of immune disorder screening. Gives information of blood’s components. Specimen = whole blood collected by venipuncture. Blood is added to tube with EDTA potassium salts (anticoagulative - allowing clear sample). 2 methods: automated/manual blood count

Question 13

How blood settles in tube

Answer 13

Plasma (top), buffy coat and erythrocytes (bottom)

Question 14

Plasma contents

Answer 14

Blood proteins: albumins, globular proteins (antibodies), fibrinogen and regulatory proteins

Question 15

Buffy Coat Contents

Answer 15

Immune cells: platelets, leukocytes, monocytes, neutrophils, eosinophils and basophils

Question 16

Automated Blood Count Outline

Answer 16

Haemology instrument uses multiple parameters and methods to count cells. Quantitative and morphological examination

Question 17

Manual Blood Count Outline

Answer 17

Visual examination of blood smear under microscope by trained personel. Quantative and morphological examination

Question 18

Low white blood cell count (low buffy coat cells) outline

Answer 18

Leukopenia. Caused by bone marrow disorder, autoimmune conditions, sepsis (immune system exhaustion), lymphoma (bone marrow cancer), dietary restriction or immune system disorders

Question 19

High white blood cell count (high buffy coat density) Outline

Answer 19

Leukocytosis. Caused by infection (bacterial/viral), inflammation, leukemia, myeloproliferative disorders, allergies and tissue death

Question 20

Neutrophil Count elevated and lowered causes

Answer 20

Elevated: acute infection, autoimmunity. Lowered: sepsis

Question 21

Lymphocyte ( B and T cells) Count elevates and lowered immune cells

Answer 21

Elevated: chronic infection, malignancy. Lowered: sepsis, HIV

Question 22

Monocytes count elevated/lowered causes

Answer 22

elevated: chronic inflammation. lowered: N/A

Question 23

Eosinophils elevated/lowered count causes

Answer 23

elevated: parasitic infection. lowered: N/A

Question 24

Basophils elevated/lower count causes

Answer 24

Elevated: allergy. Lowered: N/A

Question 25

Differential blood smear function

Answer 25

Visually observe morphology of cells (evaluate malignancy) and see how count is skewed

Question 26

Acute Lymphoblastic Leukemia

Answer 26

Accumulation of high levels of progenitor lymphoid (t and B cell precursor) cells. Crowd out other cells resulting in reduced erthrocytes, mature leukocytes and platelets

Question 27

Acute myeloid leukemia

Answer 27

Accumulation of myeloid progenitor (neutrophil/eosinophil/basophil). reduces erythrocytes, leukocytes and palettes

Question 28

Chronic myeloid leukemia

Answer 28

Accumulation of mature myeloid cells (basophils, eosinophils, nutrophils)

Question 29

Serum Protein Electrophoresis Outline

Answer 29

Diagnoses abnormal protein production. Ordered for protein in urinary, malignancy test, autoimmune disease and acute/chronic infection. Preformed on blood serum or CSF acquired by venipuncture and stored in serum separating tubes

Question 30

Other names for antibodies

Answer 30

gamma globulin = immunoglobulin

Question 31

Electrophoresis Method

Answer 31

Electricity passing through cell separates proteins out based on size, heaviest moves least (albumin) and lightest moves most (gamma globulin). Able to observe density of proteins based on colour (more dense = darker).

Question 32

Normal densities

Answer 32

Albumin is most dense, gamma globulin = most dense globulin (second most dense on sheet)

Question 33

Monoclonal/ M-protein Gammopathy

Answer 33

Indicator of malignancy. Identified by narrow dense band (same height as albumin) of immunoglobin (1 particular antibody being produced in excess)

Question 34

Polyclonal Gammopathy Outline

Answer 34

Indicator of infection. Identified by broader denser then average peak (multiple antibodies being expressed by multiple plasma cells)

Question 35

No peak outline

Answer 35

Indicates immunodeficiency. Plasma cells aren't producing antibodies

Question 36

2 types of antibody light chain

Answer 36

Kappa and Lambda

Question 37

Immunofixation Electrophoresis Outline

Answer 37

Used to evaluate exact antibodies in infection

Question 38

Immunofixation Electrophoresis Method Outline

Answer 38

Add patient serum to 6 wells (1 for each antibody), antigen-antibody complex precipitates in gel and entire gel is stained. Identifies immunoglobulin present in monoclonal bands. Determines presence of heaviny chain (IgA,IgG..) and determines presence of light chain

Question 39

Myeloma Outline

Answer 39

Monoclonal M protein (mainly IgG) . Symptoms: severe anaemia, bone pain, weakness and reoccurring infections