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Flashcards in Immunological Testing Deck (31):
1

what is immunology self reactivity?

breakdown of self-tolerance

2

What are the factors influencing autoimmunity?

genetic factors, age, exogenous factors

3

How is autoimmunity produced?

Organ specific or non-organ specific

4

Describe the pathophys for organic specific autoimmunity

antibodies are directed at a single target organ. Form immune complexes that deposit in tissues and activate complement system which leads to inflammation. Causes tissue damage, lesion deposits in target organ, and tendency toward cancer development in target organ.

5

Describe the pathophys for non organic specific autoimmunity

produce antibodies to nuclear or cytoplasmic antigen. form immune-complexes that deposit in tissues and form lesions. They activate complement system which leads to inflammation.

6

what is sle?

chronic systemic inflammatory autoimmune disease that beings in young adulthood and is more common in women (10:1). It affects AA and hispanics more than whites.

7

What are the symptoms of SLE?

arthritis, maialse, fever, weight loss, maculopapular rash, glomerluonephritis, nephritis, renal failure, alopeciea, anemia, purapura

8

What is the screen for SLE?

ANA= antinuclear antibody screen. There are two methods present. IFA Hep-2 (fluorescent) and EIA (no flurosence)

9

is ANA specific?

no, there is low diagnostic specificity because many of the antibodies associated with other autoimmune diseases. (2% of healthy persons test positive and 75% of elderly test positive)

10

What does a positive ANA indicate?

a nuclear antibody is present. it is not specific because many diseases are associated with positive ANA. around 75% of elderly people will test positive.

11

What is considered a "normal" titer for ANA

<1:40.

12

Follow up testing for ANA...if original ANA was positive, and the titer was negative then what does that mean?

either no disease, in treatment, or in remission

13

If the ANA titer is positive, then what additional follow up testing should you do?

Anti-dsDNA
Anti-histone
Anti-Sm

14

Anti-dsDNA

if this is positive, there is a high indication that this is SLE

15

Anti-histone is most often positive with...

drug induced lupus

16

If Anti-sm if involved, then they are more likely to have what?

renal involvement.

17

What is drug induced lupus?

a syndrome where SLE-like symptoms and antinuclear antibodies appear in patients taking certain drugs like procainamide, phenytoin, hydrazine, isoniazid. Patients will show rapid improvement once the drug is removed.

18

What is RA?

chronic inflammatory autoimmune disease. It primarily affects joints leading to cartilage destruction and periarticular erosions into bone. Associated with multiple organ involvement in some patients: soft tissue, heart valves, myocardium, lungs and spleen.

19

What is the pathophys for RA?

Immune complex deposits, leading to inflammatory activity in joints, loss of function, destruction, disability, deformity. Disease progression varies, with spontaneous remissions. mainly affects women

20

What are the symptoms of RA?

malaise, fever, weight loss, joint pain, stiffness develops after periods of inactivity

21

What is rheumatoid factor?

Autoantibody (most often IgM) that binds to Fc region of IgG.

22

How will you screen for RA?

RF tests. Do a quantitate RF if test is negative.

23

Does a positive RF confirm RA? Does a negative test r/o RA?

no to both

24

How is disease progression monitored?

with ESR and CRP

25

What is Hashimoto's thyroiditis?

chronic autoimmune thyroiditis. Thyroid target of autoantibodies: antithyroglobulin antibody and anti-microsomal antibody. No thyroid hormone is produce, and that leads to hypothyroidism and goiter

26

What is grave's diseasE?

thyroid targets of autoantibodies:
1. TSH receptor antibody (TRAB)
2. TSI
3. LATS
4. TPO
This stimulates hormone synthesis which causes hyperthyroidism, goiter, and exopthalamus.

27

What is PBC?

Chronic autoimmune liver disease.

28

What is the antibody target in PBC?

targets bile duct tissue of the liver.

29

What are the will be elevated in PBC?

+ ANA, AMA and increased ALK phosphatase, and increased GGT

30

What is the target in Autoimmune hepatitis/CAH?

attacks the hepatocyte (smooth muscle tissue)

31

What is pernicious anemia?

antibody targets gastric mucosa preventing HCL, intrinsic factor, and pepsin secretion. You will see malabsorption and anemia.