Immunology Lab Flashcards
(44 cards)
Monoclonal Gammopathies are also called
plasma cell dyscrasias
What occurs in monoclonal gammopathies?
There’s an abnormal proliferation of a clone of Ig secreting cells (usually plasma cells) resulting in the production of monoclonal (M) antibody (protein)
- All antibodies they produce are identical b/c they’re from the same clone
Antibodies in multiple myeloma
IgG, IgA, IgE, IgD, or light chains only
Primary amyloidosis is often referred to as
Bence Jones proteins
___ is produced in primary amyloidosis
excess free light chain
Example of lymphoproliferative disorder in primary amyloidosis. what antibody to they make?
waldenstrom’s macroglobulinemia
Only makes IgM
___ is a classic symptom of patients w/ multiple myeloma
Bone pain
Over time, monoclonal or polyclonal antibody will be major antibody in patients plasma as disease progresses
Monoclonal
___% of patients have mandibular involvement for myeloma patients, and 15% of them have ___ showing up in mandible at first
30
primary presentation
Describe serum protein electrophoresis (SPE). what are the steps?
performed to detect the presence of an M protein suggesting a diagnosis of multiple myeloma or waldenstrom’s macroglobulin
Patient serum is placed on gel → protein w/ greatest negative charge migrates to positive end of electrode → gel is put in densitometer which draws out what different patients serum looks like
___ migrates in serum protein electrophoresis
Albumin
If a patient has ___, the gamma globulin region is down to the baseline b/c patient wouldn’t be making antibodies
x-linked ammaglobulinemia
Describe monoclonal response in serum protein electrophoresis
a clone of plasma cells expands & makes same antibody & produce M protein
Describe polycloncal response in serum protein electrophoresis
different clones of cells contribute to the pattern & make antibodies w/ different specificities so migrate differently
- This is seen in normal patients
When is the earliest detectable time for patients w/ multiple myeloma?
Close to patient death, so have to treat aggressively
A polyclonal response is also called ___. Is it cancerous or benign?
plasma cell granuloma
Benign
___ is a form of multiple myeloma
Plasmacytoma
Immunohistochemical staining steps
- Tissue biopsy + add antibody against kappa (reacts w/ kappa light chain) to 1 section & a 2nd section against lambda (reacts w/ lambda light chain) & both antibodies are labeled w/ an enzyme wash to remove excess antibody + add enzyme substrate
- Then look for color deposit in tissue when enzyme activates substrate
If you have a lesion in the mouth you need to do what to determine if it’s malignant or benign?
Need to stain tissue for kappa & lambda light chain expression
If plasma cell stains only for kappa or only for lambda
If plasma cell stains both for kappa & lambda
multiple myeloma
granuloma (polyclonal response)
Amyloid deposits may consists of ___
free monoclonal kappa or lambda light chains has deposited in tissue
How do stain amyloid deposits to see them under a light microscope? What will you see?
stain the tissue w/ congo red & under a light microscope w/ polarized light & you’ll see apple-green birefringence
history of blurred vision & bleeding gums is what type of monoclonal gammopathies
Primary amyloidosis, specifically waldenstrom’s macroglobulinemia
Describe IgM in waldenstrom’s macroglobulinemia. It is associated w/ ___ syndrome
IgM is so large that it remains in blood (Increase of IgM in blood) & won’t go into tissue (doesn’t readily get out of vascular system) & has difficulty crossing mucosa b/c IgA competition
hyperviscosity syndrome
