ImmunoSero Flashcards
(567 cards)
1
Q
Network of organs
A
Immunology
2
Q
Function of Immunology (RRRD)
A
Recognize
Respond
React
Destroy
3
Q
PRIMARY Immune system organs
A
Bone marrow
Thymus
4
Q
SECONDARY Immune system organs (5)
A
Spleen
Lymph node
MALT
GALT
Peyer’s patches
5
Q
Site of B cell maturation
Produce hematopeitic stem cells
A
Bone marrow
6
Q
Functionally similar to appendix in humans
A
Bursa of Fabricious
7
Q
Cells that are not committed (lymphoid, myeloid, erythroid progenitors)
A
Stem cells
8
Q
Site of T cell maturation and differentiation
A
Thymus
9
Q
Site of T and B cell encounter
A
Secondary Immune System Organs
10
Q
Houses the lymphoid (B and T cells)
A
MALT/ Mucosa Associated Lymphoid Tissue
11
Q
Small pox vaccine; cross-immunity
A
Edward Jenner
12
Q
DISCOVER Phagocytosis
A
Haeckel
13
Q
EXPLAIN Phagocytosis - Cellular Theory of Immunity
A
Metchnikoff
14
Q
Mendelian Inheritance
A
Gregor Mendel
15
Q
Live, attenuated chicken cholera and anthrax vaccine
A
Louis Pasteur
16
Q
Humoral theory of immunity
A
Emin Von Behring, Kitasata
17
Q
Type IV Hypersensitivity Demonstration
A
Koch
18
Q
Discover the complement
A
Jules Bordet
19
Q
Antibody formation theory
A
Ehrlich
20
Q
Immediate-Anaphylaxis Hypersensitivity
A
Portier, Richet
21
Q
Discover the Opsonins
A
Almroth Wright
22
Q
Large intestinal organ
A
Liver
23
Q
Cells that can be found on: Chronic dse, tumor, organ donation
A
T cells
24
Q
Compromised T cell immunity
A
HIV
D’george syndrome
Nezelof’s syndrome
25
Thymus is located in the:
Back of the sternum, near the heart
26
Largest external organ
Skin
27
Discover the C reactive protein
Tillet and Francis
28
Discover the Ag-ab binding
Marrack
29
Polio vaccine
Salk and Sabin
30
Oral polio vax
Sabin
31
Yellow fever vaccine
Reed
32
Clonal selection theory
Burnet
33
Discover the Monoclonal Abs
Kohler, Milstein
34
First immunoassay that used radioisotope
Radioimmunoassay
35
Discover the radioimmunoassay
Rosalyn Yallow
36
Year the thew T cell receptor gene was discovered
1985-1987
37
Antibody Diversity
Susumo Tonegawa
38
Discover the HPV vaccine
Frazer
39
T or F
HPV Vaccine is not allowed or given to men.
FALSE
40
Types of Immunity
Innate
Adaptive
41
Innate or Adaptive:
Non-specific
Natural
Without memory
Phagocytosis
Non- specific
Short-term
Innate
42
Innate or Adaptive:
Specific
Stimulated
With memory
T and B cell activation
Specific
Long-term
Adaptive
43
Pathogen Recognition for Innate Immunity
TLR or Toll-Like Receptors
44
Pathogen recognition for Adaptive Immunity
Memory cells (ex. Booster shot)
45
Mechanism of Immunologic Injury:
- Allergic or Anaphylactic
- innate
- Basophils and mast cells
Type 1
46
Mechanism of Immunologic Injury:
- Cytologic
Type 2
47
Mechanism of Immunologic Injury:
- Immune complex formation
- Ab attached to organs
Type 3
48
Mechanism of Immunologic Injury:
- Cell-mediated or delayed
- autoimmunity
Type 4
49
Responses of INFLAMMATION (3)
Vascular
Cellular
Repair/ Resolution
50
2 parts of Innate Immunity
External defense
Internal defense
51
The defense system that prevents entry of pathogens into the body
External defense
52
Defense system that kills pathogen that entered and established inside the body
Internal defense
53
pH of skin to prevent infection
4.8 to 6.4 pH
54
Normal flora in the skin
S.epidermidis
55
Normal flora in the oral cavity
Viridans strep.
56
Normal flora in the vagina
L.acidophilus
57
Lactate and fatty acid maintain skin at
5.6 pH
58
Soluble factors in the internal defense system
APR or Acute Phase Reactants
59
Structural barriers: Physical
Unbroken skin
Mucosal membrane
Tears
Sweat
Hair/Cilia
60
Structural barriers: Biological
Gut
Skin
Oral cavity
Vagina
Intestine
61
Gut produce: __________ that binds negatively charged surface if certain bacteria and penetrate to kill
Colicins
62
Bacteria that can be found in the intestine
Gram - anaerobic or bacteroides
Enterobacteriaceae
63
Cells for Cellular Factors (4)
Basophils and mast cells
Phagocytic cells
NK cells
Innate lymphoid cells
64
- Histamine
- Regulates T helper cell response to stimulate B cells to produce IgE
- Short life span
- Located in the BV
Basophil
65
- More histamine
- Has CP, ALP, Proteses
- For allergic rxn and ag presentation
- Larger
Mast cells
66
Growth factor for endothelial cells
VeGF or Vascular Endothelial Growth Hormone
67
- Vasoactive amine
- Dilate the BV locally
Histamine
68
Produced by in the BV for dilation and autocrine signaling
Nitric oxide
69
What happens to BV if dilated?
Will have SPACES
Heparin will control RBCs not to go out
70
Enzyme that destroys proteins
Proteases
71
How many IgE is needed to activate mast cells?
2 IgE
72
Leukotriene inhibitor
Montelukast
73
Arachidonic acid produces (2)
Prostaglandin
Leukotrienes
74
Ig for
- Th1
- Th2
- Th17 & 9
Th1= IgG & IgM
Th2 = IgE
Th17 & 9 = IgG ang IgM
75
Th1
Viral
76
Th17 & 19
Bacterial
77
Increasing amount of exposure
Desensitization
78
Given to px with anaphylactic shock
Epinephrine
79
- Principal phagocyte/ first to go to the site of infection
- Bacterial infx
Neutrophils
80
Other name for Neutrolphil
Segs
Segmenter
MIcrophage
81
2 population granules of Neutrophil
Primary/ Azurophilic
Secondary/ Specific
82
Primary granules contain:
MPO
Lysozyme
Elastase
Proteinase-3
Cathepsin G
Defensins
83
Destroys elastin
Elastase
84
T or F:
Proteinase-3 has anti-bacterial property
True
85
Secondary granules contain:
Lysozymes
Lactoferrins
Collagenase
Gelatinase
Respiratory burst components
86
T or F:
Respiratory burst components are stored in secondary but formed in primary granules.
True
87
Fat that is destroyed by macrophage
Mycolic acid
88
Leukocytes based on abundance
Neutrophil
Lymphocytes
Monocytes
Eosinophil
Basophil
89
Phagocytic cell:
- Regulation of immune response
- mast cell indirect phagocytosis
- increased in allergic rxn
- increased in parasitic infection
Eosinophil
90
Contents of Eosinophilic granules
Catalase
Lysozyme
Cytokines
Growth factors
Cationic proteins
Major basic proteins
Histaminase
91
Create a hole in helminths in basic pH
MBP
92
Largest cell in the peripheral blood
Monocytes or MAcrophages
93
Monocyte 1st type of granules components:
Peroxidase
ACP
arysulfatase
94
Monocyte 2nd type of granules components:
B-glucoronidase
Lysozyme
Lipase but no ALP
95
Interleukins released by the monoyctes during phagocytosis
1B
6
12
96
Interleukin that go to liver to produce CRP to ingest organism
Il-6
97
Interleukin that regulate temperature or stimulates fever
Il-1B
98
Interleukin that activate NK cells for anti-tumor activity
Il-12
99
Coat organism to be recognized
Opsonins
100
Two types of macrophages
M1 - Classically activated
M2- Alternatively activated
101
T or F:
Monocytes are lipid in nature.
True
102
What interferon activates M1
IFN-y
103
What Il activates M2 (2)
Il- 13 and Il- 4
104
M1 produces __, ___, ___ during phagocytosis
ROS
NO
Lysosomal enzymes
105
M1 produces ___, ____, ____, ____ during inflammation
Il-2
Il-12
Il-23
Chemokines
106
M2 produces growth factors and TGF-B for:
Tissue repair
Fibrosis
107
M2 produces Il-10 and TGF- B / Transforming growth factor - B
Anti-inflammatory effects
108
Most effective antigen-presenting cell and most potent phagocyte
Dendritic cells
109
Phagocytic cells
Neutrophil
Eosinophil
Monocyte or macrophage
Dendritic cells
110
Phagocytic cells for healing and repair
Macrophage and dendritic cells
111
MACROPHAGE: Lungs
Dust cells
Alveolar macrophage
112
MACROPHAGE: Liver
Kupffer cells
113
MACROPHAGE: Bone
Osteoclast
114
MACROPHAGE: Placenta
Hoffbauer cells
115
MACROPHAGE: Brain
Microgilial cells
116
MACROPHAGE: Kidney
Mesangial cells
117
MACROPHAGE: Connective tissue
Histiocytes
118
MACROPHAGE: Spleen
Littoral cells or splenic macrophage
119
MACROPHAGE: Blood
Monocytes
120
MACROPHAGE: Skin
Langerhans cells
121
MACROPHAGE: Synovium
Type A lining cells
122
cell eating cell
Phagocytosis
123
Steps in Phagocytosis (6)
Initiation
Chemotaxis
Recognition
Ingestion/ Engulfment
Digestion
Exocytosis/ Egress
124
2 types of Phagocytosis
Direct
Indirect
125
Direct phagocytosis via:
PPRR - organism
PAMP - WBC
126
Indirect phagocytosis via:
Opsonins
127
Most potent chemoattractant
C5a
128
Most potent opsonin
CRP
129
Physical contact bet. WBC and foreign cell
Initiation
130
Recruitment of immune cells to the site of infxn
Chemotaxis
131
Chemical messengers that aid the WBC movements
Chemoattractants or Chemotaxin
132
Chemoattractant
65a
C3a
CRP
Il-8
133
Squeezing out of WBC from blood vessel to tissue
Diapedesis
134
Process of Diapedesis
Rolling
Adhesion
Transmigration
135
Rolling:
L-selectin with bind to
Sialyl-Lewis X
136
Adhesion:
Integrin will bind to
E-selectin
137
T or F:
Lewis is produced in endothelial cells.
True
138
Direct phagocytosis:
- distinguish self from non-self
PPRR
139
Direct phagocytosis:
- present in the foreign organism
PAMP
140
PAMP: Gram +
Peptidoglycan
141
PAMP: Gram -
Lipoprotein
LPS
142
PAMP: Yeast
Zymosan
143
PAMP: FLagellae
Flagellin
144
Receptors in DIRECT phagocytosis
PPRR
PAMP
TLR/ Toll-like receptor
CLR/ C-type lectin receptor
RLR- Retinoic Acid - Inducible gene I-like receptor
NOD/ Nucleaotide-binding oligomerization domain receptor
145
Examples of opsonins
CRP
C3b
Antibodies
146
Light chain enhancer of activated B cell
NF-kB
147
Toll protein is discovered from
Fruit fly - Drosophila
148
CLR binds to ______ and ____ that are found in the fungal cell walls
Mannan
B-glucans
149
Forms Phagosome or vacuole
Ingestion or Engulfment
150
Lysosomal granules + Phagosome =
Phagolysosome
151
Defect in lysosomal enzyme
Chediak Higashi
152
Secondary Digestion Pathway
HMP or Hexose Monophosphate Shunt
153
Digestion of microbes by hydrolytic enzymes
Secondary digestion
154
Defect in NADPH Oxidase
Chronic Granulomatous Disease
155
2 secondary digestion process
Oxygen dependent
Oxygen independent
156
- Oxidative burst via HMP shunt
- Produce Oxygen Radicals ( Superoxide, Hydrogen Peroxide, Hypochlorite)
Oxygen dependent
157
- NADPH Oxidase
- Depolarization membrane
- Hydrogen and potassium will enter then alter pH then activate Proteases
Oxygen independent
158
Oxygen radicals that reacts with superoxide
Nitric oxide
159
Convert NADP+ to NAD+
NADPH oxidase
160
Convert Superoxide to Hydrogen Peroxide
Superoxide dismutase
161
Convert Hydrogen Peroxide to Hypochlorite
Myeloperoxidase
162
Damages cell membrane
Cathepsin G
163
Release debris outside the cell
Exocytosis or Egress
164
Toll-like receptors found on the cell surface
TLR 1 - Techoic acid
TLR 2 - Lipoproteins
TLR 4 - Lipopolysaccharides
TLR 5 - Flagellin
TLR 6 - Lipopeptides, Lipoteichoic acid, Zymosan
165
Toll-like receptors found on the endosomal compartments
TLR 3 - dsRNA
TLR 7 and 8 - ssRNA
TLR 9 - dsDNA
TLR 10 - unknown
166
- cytoplasm
- serves as intracellular sensors for microbial products
- inflammatory responses
Nod-like receptors or Nucleotide oligomerization domain
167
- cytoplasmic sensors
- production of type 1 interferon
Rig-1-like receptors or Retinoid-inducible gene
168
- Kiss of death
- First line of dense against cells that are: virally infected, infected with intracellular pathogen, tumor cells
NK cells
169
Large Granular Lymphocyte
NK cells or Natural Killer Cells
170
T or F:
NK cells are positive in CD16 (FcRy) and CD 56 (CAM)
True
171
T or F:
IFN-y and TNF-a produces cytokines when activated (NK cell)
True
172
Link between innate and adaptive immunity
NK cells
173
NK cells monitors potential target cells thorugh (2)
Inhibitory signal
Activating signal
174
Inhibitory signal:
Receptors which bind to MHC 1
CD49/ NKG2A
175
Activating signal:
Receptors (cancer cells)
CD16
NKG2D
176
Activating signal:
Receptors (viral infxn)
ADCC: CD16
177
ADCC
Antibody-dependent cell cytotoxicity
178
Site: DNA virus
Nucleus
179
Site: RNA Virus
Cytoplasm
180
Process: VIRUS
- "A-P-U-M-A-R"
Attachment
Penetration
Uncoating
mRNA
Assemble
Release
181
- Bone-marrow-derived cells
- with lymphocyte morphology but lack markers from lymphocytes
Innate lymphoid cells
182
Tissue signal: Type 1 effect
against intracellular oganism
183
Tissue signal: Type 2 effect
parasitic helminth and allergy
184
Tissue signal: Type 3
extracellular organism
185
Most potent antigen-presenting cell
Dendritic cells
186
Follows phagocytosis
Antigen Presentation
187
Present Ag to CD8+ cells
MHC Class 1
188
Present Ag to CD4+ cells
MHC CLass 2
189
Type of Signal (Antigen Presentation):
- CD 3 proteins
- Z chains
- TCR heterodimer
Type 1
190
Type of Signal (Antigen Presentation):
- CD28 (T cell) to CD 80/26 (Dendritic cells)
Type 2
191
Type of Signal (Antigen Presentation):
- IL-12
Type 3
192
Surveillance cells that checks the MHC Class 1
Nk cells/ T cell
193
Major Histocompatibility Complex Location
Chromosome 6p
194
MHC produces
Human- Leukocyte Anitgen (HLA)
195
T or F:
Major function of MHC is to aid in antigen presentation to T cells
True
196
MHC test of choice
Molecular methods (transplant institute)
197
Type of MHC:
- All nucleated cells
- Present to CD 8+
- Endogenous antigen
- Viral or cytosol antigen
- Ag: HLA A,B,C
- 3 alpha, 1 beta
MHC Class 1
198
Type of MHC:
- B cells, phagocytic cells (Macrophages, neutrophils, dendritic)
- Exogenous antigen
- Bacterial antigen
- Ag: DP, DQ, DR
- 2 alpha, 2 beta
MHC Class 2
199
Type of MHC:
- RBC
- Not capable of antigen presentation
- Ag: Benett Goodspeed
MHC Class 3
200
Disease = HLA present:
Goodpasture's
Multiple sclerosis
DR2
201
Disease = HLA present:
SLE
Autoimmune thyroid disease
Dermatitis
Herpetiformis
DR3
202
Disease = HLA present:
Rheumatoid arthiritis
DR4
203
Disease = HLA present:
Ankylosing spondylitis or Ankyloarthritis or Bamboo Spine Disease
B27
204
No intervertebral disc
Ankylosing spondylitis
205
Disease = HLA present:
Celiac disease
Dermatitis Herpetiforms
B8
206
Disease = HLA present:
Psoriasis vulgaris
Cw6, B17, B13
207
Disease = HLA present:
Congenital Adrenal Hyperplasia
B47
208
Laboratory Test for MHC (Old methods)
Microlymphocytotoxicity Test
Mixed Lymphocyte Reaction
209
Newer detection methods for MHC
ELISA Crossmatch
Flow Cytometric Antibody Screen
Multiplex Immunoassay (LUMINEX)
210
- Tests for HLA Antigen
- Use purified HLA ag instead of lymphocytes
ELISA Crossmatch
211
- Use T or B lymphocytes or purified HLA ag
- Coat into microparticles
Flow Cytometric Antibody Screen
212
- Use Px's HLA ag
- + Mean Fluorescence Intensity
Multiple Immunoassay (LUMINEX)
213
LAD Score Method
Logarithm of the Odds score
214
Biologic Response Modifiers
Humoral Factors
215
4 main sources of BRMs from the mononuclear leukocytes
B lymphocyte
T lymphocyte
NK lymphocyte
Monocytes & Macrophages
216
T or F:
Monocytes & Macrophages secretes IFN-a, Il-1, TNF-a, GM-CSF, M-CSF
True
217
- Small soluble proteins
- Chemical signal functions to recruit other immune cells
Humoral Factors
218
- Polypeptide product of activated cells
- Control a variety of cellular responses
Cytokines
219
- First cytokine activity described
- Retention and accumulation of phagocytes at the sites of infxn
Migratory Inhibitory Factor (MIF)
220
MIF or Migratory Inhibitory Factor Examples
Interleukins
Tumor Necrosis Factor
Interferon
Transforming Growth Factor
221
Innate Immunity Cytokines
Chemokines
IFN Type 1 (a & B)
Il-1,6,10,12,15,18
TNF
222
Adaptive Immunity Cytokines
IFN- y
Il-2,4,5,13
Lymphotoxin
TGF-B
223
Types of Cytokine:
- affects same cell that secreted it
Autocrine
224
Types of cytokine:
- secreted by nearby cells
Paracrine
225
Types of cytokine:
- secreted by the circulatory system
- affect distant celss
Endocrine
226
Massive overproduction of cytokine leading to shock, multi-organ failure, death
Cytokine Storm
227
Rapid screening of bacterial infx secondary to covid
Procalcitonin
228
- COVID Receptor
- Induce to produce more cytokine
ACE-2 Receptor
229
Functions of Interferons (3)
Enhance specific gene expression
Inhibit cell proliferation
Augment Immune effector cells
230
Type of interferon:
- Leukocyte IFN
- activates NK cells
- inhibits viral replication
Type 1; IFN-a
231
Type of interferon:
- Immune IFN
- Secreted by T cells, Th1, NK cells
Type 2; IFN-y
232
Type of Interferon:
- Fibroepthelial IFN
- secreted by dsRNA-induced fibroblast
Type 1; IFN-B
233
Principal mediator of Acute Inflammatory response to Gram -
Tumor Necrosis Factor
234
effective against Gram + except streptococcus
Beta- lysin
235
Site of production of TNF
LPS-activated macrophage
236
Recruit and activate phagocytes to kill microbes
TNF
237
TNF Concentration:
- acute inflammation
Low concentration
238
TNF Concentration:
- systemic effect of inflammation
Moderate concentration
239
TNF Concentration:
- causes clinical and pathological abnormalities
Large concnetration
240
TNF-a
Cachetin
241
TNF-B
Lymphotoxin
242
- Released by Platelets during coagulation
- heat stable
Beta-lysin
243
Multicolony stimulating factor
Il-3
244
- Peptides and proteins
-Serves as signal molecules
- Functions through separate receptor
- Leukocyte is the site of production
Interleukin
245
- glycoproteins
- increase rapidly during infxn, injury, tse trauma
- promote phagocytosis and limit destruction through proteolytic enzymes
APR or Acute Phase Reactants
246
T or F:
APR is initiated and sustained by cytokine Il-1, Il-6, TNF-a
True
247
Half-life of APR
2-4 days but CRP has 5-7 hrs
248
APR Protein:
- for opsonization and complement activation
- main substrate is Phosphocholine
CRP Or C reactive protein
249
APR Protein:
- Activate monocytes and macrophages
- Increase in chronic inflammation, atherosclerosis, cancer
Serum Amyloid A
250
APR Protein:
- general plasma inhibitor of proteases
- inhibites eleastase
a-1-antitrypsin
251
APR Protein:
- general plasma inhibitor of proteases
- inhibits elastase
- regulates elastase, Il-1B, Il-6, TNF-a
a-1-antitrypsin
252
AAT deficiency
Premature emphysema
Liver disease
253
APR Protein:
- Nine serum proteins
- Present and mediates inflammation
Complement
254
APR Protein:
- Antioxidant
- Binds irreversibly to free hemoglobin
Haptoglobin
255
APR Protein:
- cleaved by thrombin to produce fibrin clot
- promotes aggregation of RBC and platelet by making blood viscous
- Normal value = 200-400 mg/dl
Fibrinogen
256
APR Protein:
- Principal copper-transporting protein
- Binds 6 cupric ions per molecule
- Wilson’s disease
- Normal value: 20-40 md/dl
Ceruloplasmin
257
Overall body reaction to injury or invasion by an infectious agent
Inflammation
258
T or F:
The main purpose of inflammation is to attract cells to the site of infection for phagocytosis
True
259
Roles of inflammation (IAS)
Initiate
Amplify
Sustain
260
Primary process in inflammation
Localized inflammation
261
Final process of inflammation
Resolution and repair by Fibroblast
262
- Early stage of infection
- Shirt term
Acute Inflammation
263
- Prolonged infection
- Long term
Chronic inflammation
264
Resolution and repair makes fibroblast proliferate resulting to
Total repair
Abscess formation
Granuloma formation
265
Cardinal signs
Rubor - erythema
Calor - hear
Tumor - edema
Dolor - pain
Functio laesa - loss of function
266
Pressure sensor
Pacinian corpuscle
267
Protein complex that recognizes products of dead cells
Ex. Uric acid - by product of purine
Inflammasome
268
Components of Inflammasome
Sensor protein
Adapter
Enzyme caspase-1
269
Activate caspase-1
Il-B
270
Third line of defense
Adaptive immunity
271
Types of adaptive immunity
Humoral - abs
Cell-mediated - T cells and B cells
272
Cells of adaptive immunity
T cells and b cells
273
T or f:
Th1 = intraellular microbes
Th2 = helminthic parasites
Th3 = extracellular bacteria, fungi
True
274
- 60 o 80% lymphocyte fraction
- for cell-mediated immmunity
- selected and matures from cortex to medulla
T-cells
275
Develomental stages of Tcells
Double negative
Double positive
Mature T cells
Activated T cells
276
- No CD4 and CD8 markers
- Proliferate due to Il-7
- Gene arrangement for TCR
Double Negative
277
Selection of allele in 1 chromosome
Allelic Exclusion
278
Express both CD4 and CD8
Double Positive
279
Types of Double Positive
Positive selection - retain thymocytes with functinal tcr
MHC Selection - selects thymocytes
Negative selecttion - apoptosis of cells
Colonal deletion- eliminates clone
280
- Either CD4 and CD8 is present
- Thelper and T cytotoxic cells
Mature T cells
281
T cells with 2/3 population
T-helper cells
282
T cells with 1/3 population
T cytotoxic cells
283
- Produce CD25 (Il-2 receptor) to secrete cytokines enhnce B cell ab production
- Prevent autoimmunity
Activated T cells
284
Sub-population of Tcells
Th9 = Il-9 produtiion (extracellular bacteria)
Th17 = Il-17 and Il-22 (inflammation and bone destruction)
285
- inverted CD markers
- 1:2 ratio
AIDS
286
- For humoral mediated immunity
- in the bone marrow (stromal cells forming niches)
B cells
287
Phases of B cell development
Phase 1 - antigen independent
Phase 2 - antigen dependent
Phase 3 - differentiation of plasma cells
288
Phase 1 cells
Pro-B cells -heavy and light chain
Pre-B cells - heavy chain and u chain
Immature B cells - complete IgM
Mature B cells- surface IgD
289
Elimination of B cells bearing self-reactive receptors
Central tolerance
290
Halmark of adaptive immune system
Pre-existing diversity of receptor for Ag
291
Not an end stage cells
Surveillance cell
Lymphocyte
292
Remain in the spleen to quickly respond to blood-borne pathogens
Marginal zone b cells
293
Migrate to secondary lymphoid organs
Follicular cells
294
Most fully differentiated lymphocyte
Plasma cells
295
Activators of lymphocytes
Monoclonal - antigens
Oligoclonal - superantigens
Polyclonal - mitogens (mitosis =allow proliferation of lymphocytes)
296
B cell mitogen
Lipopolysaccharide
297
T cell mitogen
Concanavaline A
Phytohemagglutinin
298
Both T and B mitogen
Pokeweed mitogen
299
Laboratory Identification of Lymphocytes (3)
Density Gradient Centrifugation - Ficoll- Hypaque
Roswell Park Memorial Institute Medium - RPMI 1640
Flow cytometry - gold standard
300
- E-rosette Test
- CD2 receptor on sheep RBC
- End product: cytokines
- Location: Paracortical region
T cell
301
- Surface Ig Detection
- IgD and igM on the surface of naive B cells
- End product: Abs
- Location: Cortical region
B cell
302
Forms of Acquired Immunity
Active Natural - infxn
Active Artificial - vaccination
Passive Natural - in-vivo transfer
Passice Artificial - infusion of plasma/serum
303
- Proteins
-Binds with Ag
- Site of Production = Plasma cells, spleen, lymph nodes
- Determinant = PARATOPE
Antibody
304
Antibody Structure
2 light chains - kappa or lambda
2 heavy chains - gamma, alpha, delta, epsilon, mu
305
Change in class of antibody
Isotype switching
306
Structural regions of Antibody (5)
Variable = amino terminal end
Constant = carboxy terminal end
Hinge = bet. Ch2 and ch3; PROLINE
Fc = fragment of crystallization; WBC binding site
Ch2 and Ch3 = complement binding site
307
Enzyme digestion (2)
Papain = 1st disulfide bond, 3 fragments
Pepsin = 2nd disulfide bond, 2 fragments
308
Unit of sedimentation rate of Immunoglobulin
Svedberg
309
Heavy chain differences
Isotypes
310
Minor variation
Allotype
311
Variable part of LC and HC
Idiotypes
312
pH for Ab gamma region
8.6
313
Production of monoclonal antibody by a hybridoma cell (immortally producing abs)
Hybridoma technology
314
Plasma cell + Myeloma cell
Hybridoma cell
315
Surfactant used for Hybridoma Technology
PEG or Polyethylene Glycol
316
Medium used for Hybridoma Technology
HAT or Hypoxanthine - Aminopterin - Thymidine
317
Formerly used potentiator for Hybridoma Technology
Sendai virus
318
Antibody Isotypes (5)
IgG
IgA
IgM
IgD
IgE
319
- Anamnestic response antibody
- Activate complement classical pathway
- Most abundant in SERUM
- most efficient in PRECIPITATION
- Can cross placenta
- Opsonin, viral neutralization, ADCC
IgG
320
Types of IgG
IgG1 = cross placenta
IgG2 = cannot cross immediately
IgG3 = fix complement
IgG4 = cannot fix complement; destroyed in the spleen
321
- Secretory components
- B cell production (MALT)
IgA
322
Types of IgA (2)
Monomeric IgA = blood
Dimeric IgA = secretions
323
- Primary reponse antibody
- Activates complement classical pathway
- Acute infection indication
- With joing chain or J chain
- Macroglobulin
IgM
324
Types of IgM
Monomeric IgM = surface of naive B cell
Pentameric IgM = plasma
325
- Surface of naive B cell
- Extended hinge region
- For B cell activation, maturation, differentiation
IgD
326
- Most heat labile
- Reagenic antibody/ Homocytotropic antibody
- Binds with mast cells, eosinphils, basophils
IgE
327
Antigen- Antibody Interaction:
- Association constant
- Univalent antigen
Affinity
328
Antigen- Antibody Interaction:
- Overall binding
- Multivalent antigen
Avidity
329
Antigen- Antibody Interaction:
- Test negative
- Abscence of homologous ag
Specificity
330
Antigen- Antibody Interaction:
- Test positive
- Presence of homologous antigen
Sensitivity
331
Antigen- Antibody Interaction:
- Bind similiar but not identical isotope
Cross Reactivity
332
Antigen- Antibody Interaction:
- PRIMARY Interactions (3)
Vanderwaals = hydrophobic
Ionic and hydrogen bonds = hydrophilic
Covalent bond
333
Antigen- Antibody Interaction:
- SECONDARY Interactions (2)
Precipitation = antibody + soluble antigen
Agglutination = antibody + particulate antigen
334
Stages of Agglutination (3)
Sensitization
Lattice Formation
Effect on Tissue
335
Factors that affect Ag- Ab binding
Ag - Ab ratio = Pro zone, zone of equi, post zone
pH = 6.5 to 7.5
Length of incubation
No. of antigens
Location of antigens
Centrifugation
Potentiators = LISS, PEG, Bovine albumin
Rouleaux and True agglutination = Add NSS for pseudo agglutination
Antibody isotope
Temperature = IgM (RT) , IgG (high temp)
336
Antibody generators
Antigen
337
- Antigenic determinant = Epitope
- 2 types= complete and incomplete (need haptens)
Antigen
338
Antigens capable of inducing immiune response
Immunogen
339
Forms of Antigens (3)
Autologous = induce autoantibody formation
Homologous = antibody production specific to antigen
Heterologous = cross-reaction, reacts with antibody it did not induced
340
- Small molecules
- Immunogenic when paired with high MW carrier
Haptens
341
- Added to vaccine
- Enhance immune response
- Ex. Squaline, MF-59, Freund’s complete adjuvant, Alum Precipitate
Adjuvants
342
- Antigens that cancactivate T cells by nonspecifically binding to MHC molecule
- Do not require anitgen processing
- Cytokine storm
Superantigens
343
Detectable range of test system
Linearity
344
Dengue serotype that can cause hemorrhagic fever
Dengue serotype 1
345
Traits of Immunogen (5)
Macromolecule size = > or = 10 to 100 kDA
Foreigness = Non-self (Lens protein, sperm, brain, thyroglobulin)
Chemical composition = Proteins and polysaccharides
Ability to be processed and presented with MHC
Route and dosage = IV and Intraperitoneal
346
- Least immunogenic organ
- No blood supply
Cornea
347
- Most immunogenic organ
Bone Marrow
348
Properties of Immunogens
T cell-independent = stimulate B cells directly, Ag processing is not required
T cell-dependent = Need T cell recognition, Ag processing is required
349
Induces cytolytic destruction by forming MAC to make hole in the cell membrane
Complement System
350
COMPLEMENT SYSTEM:
Inactivated at ____ for ____ mins
Must be used within _____ hrs
56 degrees celsius
30 mins
4 hrs
351
COMPLEMENT SYSTEM:
If not used within 4 hours, heat at _____ celsius for ______ mins
56 degrees
10 mins
352
Complement Pathways (3)
Classical = ab is attached to ag
Alternative = activating surfaces like LP
Lectin Pathway = lectin initiates binding of MBL/ Mannose Binding Lectin
353
Used for screening for bacterial infection
Procalcitonin
354
Regulatory Proteins (5)
C1 inhibitor / C1INH = detaches C1r and C1s from C1
Factor I = cleaves C3b and C4b
Factor H = cofactor to factor I to inactivate C3b
C4 Binding Protein = cofactor to factor I to inactivate C4b
S protein/ Vitronectin = prevents attachment of C5b67 to cell membrane
355
Disorders resulting from complement deficiency
C1 inhbitor = Hereditary Angioneurotic Edema
C1, C2, C4, C7 = SLE- like syndrome
C5 - C8 = Neisseria infection
C3 = Severe recurrent infection
C2 = most common deficiency
C9 = no known disease
356
- Exaggerated response
- harmless antigens that results to tuissue injury
- Influenced by environment and gene
- Treament: Anti-histamine, docingestant and corticosteriod
Hypersensitivity reaction
357
Monoclonal anti-IgE blocks the binding site of IgE to mast cells and basophils
Omalizumab
358
- Preferred method of screening type 1 in hypersensitivity reaction
- Smaal mamt of allergen is injected in the skin
- Wheal or flare reaction within 20 mins
In Vivo Prick Test
359
- Alternative test instead of In Vivo Prick Test
- Unable tol tolerate skin testing
Noncompetitive Solid Phase Immunoassay
360
Types of Hypersensitivity Reactions
Type 1 = allergic or anaphylactic
Type 2 = cytotoxic
Type 3 = immune complex deposition
Type 4 = delayed
361
Immune mediators for Types of Hypersensitivity Reactions
Type 1 = IgE
Type 2 = IgG or IgM
Type 3 = IgG or IgM
Type 4 = T cells
362
Immune Mechanism of Types of Hypersensitivity Reactions
Type 1 = IgE sensitized mast cells and basophils
Type 2 = ADCC destruction
Type 3 = Ag - Ab complex
Type 4 = Ag - sensitized Th1 cells to relase cytokines
363
Clinical examples for Types of Hypersensitivity Reactions
Type 1 = Anaphylaxis, allergic rhinitis, asthmas, food allergies, urticaria
Type 2 = HTR, AIHA, HDF, Drug reaction, Myasthenia gravis, Graves, Good pasteurs
Type 3 = Serum sickness, Arthus reaction, SLE, RA, Drug reaction
Type 4 = contact dermatitis, tuberculin and anergy skin test, hypersensitivity pneumonitis
364
Tests for Types of Hypersensitivity Reactions
Type 1 = In vivo skin test
Type 2 = DAT (HTR, AIHA, HDFN)
Type 3 = - Ag from animal source
Type 4 = Skin test, PPD testing (48-72 hrs)
365
- Failed tolerance results to
Autoimmunity
366
Autoimmune Diseases = Autoantibody
SLE = Anti-DNA, Anti- nuclear, Anti- ribosome, Anti-DNP
Primary biliary cirrhosis = Anti-mitochondrial
Chronic Active Hepatitis = Anti- smooth muscle antibody
Hypothyroidism = Anti- TPO, Anti-microsomzl Anti-thyroglobulin
Hyperthyroidism = Anti- TSH receptor, Anti-thyroglobulin
Goodpasteur’s Sydrome = Antiglomerular Basement Membrane (Edema)
Wegener’s Disease = c-ANCA
Churg - Strauss Sydrome = p-ANCA
DM Type 1 = Anti-insulin, Anti- Beta cells
Addison’s Disease = Abs against adrenal glands
Multiple sclerosis = Anti-myelin sheath ab
Myasthenia gravis = Anti-acetylcholine recptor
Pernicious anemia = Anti-parietal cell
Rheumatoid arthritis =Rheumatoid factor
ITP = Anti-platelet
Pemphigus vulgaris = Anti-desmosome
Bullous pemhigoid = Anti- hemidesmosome
367
Laboratory diagnosis for Autoimmunity
LE preparation
Rheumatoid factor
Immunochromatography
Immunofluorescent staining
368
Circular dsDNA substrate in anti-dsDNA detection
Crithidia lucilliae
369
Immmunofluorescent staining results:
Fluorescence patterns
Diffuse = anti-dsDNA and anti- Histone
Nucleolar = anti- RNP
Speckled = most common; anti-RNP and anti-smith
Peripheral = anti-DNA and anti-lamins
Centromere = anti- centromere; CREST (Calcinosis, Reynaud’s, Esophageal dysmotility, Sclerodactyly, Telangiectasia
370
Transplant immunology (3)
Allorecognition
Graft vs. Host Disease
Graft rejection
371
Allrecognition types
Autograft = same individual
Xenograft = 2 individuals, diff species
Allograft = 2 individuals, same species
Sygeneic graft = identical twins
372
Immunocompetent lymphocytes induced to immunocompetent individuals
GVHD
373
Type of graft rejection
Hyperacute = within minutes, humoral
Accelerated = 2 to 5 days, cell mediated
Acute = 7 to 21 days, cell mediated
Chronic= > 3 months, cell mediated
Immunopathologic damage to the new organ = > 3 months, immune complex disorder
374
Uncontrolled growth of normal cells
Neoplasia
375
Types of neoplasia
Benign = non-cancerous
Malignant = cancerous (-oma)
376
Neoplasia:
- Epithelial cell
Carcinoma
377
Neoplasia:
- connective tissue
Sarcoma
378
Neoplasia:
- bone marrow
Leukemia or Lymphoma
379
Protein seen in multiple myeloma
Bence Jones Protein
380
Spread of cancer cells
Metastasis
381
Tumor markers:
ONCOFETAL ANITGENS (2)
CEA = gastrointestinal, colorectal
AFP = hepatoma
382
Tumor markers:
CARBOHYDRATE ANTIGENS (4)
CA125 = Ovarian
CA15-3 = Breast
CA19-9 = Pancreatic, gastric
CA72-4 = Gastric
383
Tumor markers:
ENZYMATIC MARKERS (2)
PSA = Prostate
ALP = Bone
384
Tumor markers:
HORMONES (3)
Beta-HCG = Testicular
Calcitonin = Medullary thyroid
Gastrin = Gastric
385
Tumor markers:
ONCOGENES (3)
BRCA-1 and 2 mutations = breast
Her2neu = breast
CYFRA21-1 = lung
386
Tumor markers:
OTHERS (4)
Bombesin = oat cell
IGF-1 = pituitary
Il-2 = leukemia
NMP/ Nuclear Matrix Protein= bladder
387
Depleting immune system
Immunodeficiency
388
Immunodeficiency classification (2)
Primary = inherited (genetics)
Secondary = other factors (aging, stress, chronic disorders, viruses, lifestyle)
389
Immunodeficiency:
Phagocytic cell Deficiency (5)
CGD = defect incytochrome B
MPO def = defect in HMP shunt, decreased conversion to hypochlorite
G6PD def = genetic impairment of Neutophil’s aerobic system
Chediak higashi = genetic abnormal fusion of neutrophil granules (Albinism, photosensitivity, giant platelets)
Lazy leukocyte syndrome = (Job syndrome, Tuffsin def, Actin dysfunction)
390
Immunodeficiency:
B cell immunodeficiency (4)
X-linked Bruton’s Agammaglobulinemia
Common variable hypogammaglobulinemia
Selective IgA deficiency = most common congenital immunodeficiency
Neonatal agammaglobulinemia
391
Immunodeficiency:
T cell immunodeficiency (2)
DiGeorge syndrome = abnormal development of thymus gland
Nezelofs syndrome = athymic px
392
Immunodeficiency:
Combined T and B cell deficiency (3)
SCD = decreased T and B cells
Wiskot- Aldrich = Triad (Thrombocytopenia, immunodeficiency, eczema)
Bare lymphocyte = defect in MHC Antigen expression (Class 1 and 2)
393
Study of fluid component of blood (Ab)
Serology
394
Most frequent encountered specimen for serology
Serum
395
Commonly used Pipette in serological testing
Micropipettes
396
Tubes used for serological testing
Red top sterile tube / Gold top tube
397
Make less concentrated solution from a reagent
Dilution
398
Types of dilution
Simple
Compound
Serial = use titer (ab strength); common: doubling dilution
399
Proportion of people who have the disease
Sensitivity
400
Proportion of people who do not have the disease
Specificity
401
Probability that positive screening test has the disease
Positive predictive value
402
Probability that negative screening test does have the disease
Negative predictive value
403
- Ab excess
- Remedy: dilution
Pro zone
404
- Ag excess
Post zone
405
- Ag closely resemble one another
- Ab formed against one will react with the other
Cross reactivity
406
Removal of bound abs
Elution
407
Attachment of unbound abs
Adsorption
408
Sensitive than slide testing
Tube testing
409
Rapid reading and only need small volume of specimen
Slide testing
410
Agglutination grading:
- no agglutinates
0
411
Agglutination grading:
- tiny agglutinates, turbid
w+
412
Agglutination grading:
- small agglutinates, turbid
1+
413
Agglutination grading:
- medium-sized, clear
2+
414
Agglutination grading:
- Large agglutinates, clear
3+
415
Agglutination grading:
- One solid aggregates, clear
4+
416
Causes of false reactions in agglutination:
False positive reaction (7)
Overcentrifugation
Contaminated glasswares
Autoagglutination
Saline stored in glass bottles
Cross-reactivity
RF, Heterophile ab
Delay in reading
417
Causes of false reactions in agglutination:
False negative (7)
Undercentrifugation
Inadequate washing of cells
Delay in testing
Incorrect incubation temp
Insufficient incubation time
Prozone phenomenon
Failure to add AHG rgt
418
Agglutination rxns (7)
Direct
Indirect
Reverse passive
Agglutination inhibition
AHG mediated
Viral hemagglutination
Hemaglutination inhibition
419
- Natural carrier of Ag
- Febrile agglutination test
- ABO Forward typing
Direct agglutination
420
Febrile agglutination test (2)
Widal = salmonella ab
Weil felix = ricketssia ab
421
- Artificial carrier antigen
- Carriers = Polystyrene latex, bentonite, beads, charcoal
- ASO latex agglutination test
Indirect agglutination
422
- Artificial carrier of ab
- CRP Latex agglutination test
Reverse passive agglutination
423
2 stages of agglutination inhibition test
1st = add soluble rgt. ab
2nd = add ag-coated latex particle
424
AHG-mediated agglutination types (2)
Direct = in vivo, spx= rbc
Indirect = in vitro , spx= serum
425
Precipitation by Light measurement (2)
Nephelometry = light scattered
Turbidimetry = light blocked
426
Passive immunodiffusion types (2)
Single = only ag diffuses
Double = both ag and ab diffuses
427
Single immunodiffusion types (2)
Linear = James Oudin test
Radial = Fahey- Mckelvy (Kinetic) & Mancini (End point)
428
- Double immunodiffusion
- Double angular diffusion
- Ag (outer) , Ab (inner well)
Ouchterlony Double Diffusion
429
Result patterns for Ouchterlony Double Diffusion Test (3)
Identity = common epitope
Non-identity = no common epitope
Partial identity = single spur
430
General steps for Electrophoresis (3)
Separation = electrophoresis
Staining = Amido black, ponceau S, coomassie brilliant blue
Densitometry = band quantification
431
Separation Electrophoresis (2)
Zone Electrophoresis = 5 bands
High resolution electrophoresis = 12 bands
432
- One stage electrophoresis
- Single ID + Electric current
- Rocket precipiti
Rocket electrophoresis
433
- One stage electrophoresis
- Countercurrent
- Double ID + Electric current
- Precipitin line
- Ag moves to anode (+)
- Ab moves to cathode (-)
Counterimmunoelectrophoresis
434
Two stage electrophoresis (3)
Classic Immunoelectrophoresis
Immunofixation electrophoresis
Crossed 2D immunoelectrophoresis
435
- Electrophoresis + Immunodiffusion
- Trough
- Precipitin arc
Classic immunoelectrophoresis
436
- Electrophoresis + Immunodiffusion
- Gel
- Precipitin bands
Immunofixation electrophoresis
437
- Electrophoresis + electrophoresis
- 2nd gel
- Precipitin rockets
Crossed 2D immunoelectrophoresis
438
Marker of ag-ab binding
Label
439
Examples of label in Labeled Immunoassay
Enzyme
Fluorescein dye
Radioisotopes
440
Steps in Labeled Immunoassay
Separation = separate bound and free reactants
Detection = label dependent
441
Physical methods for Labeled Immunoassay: SEPARATION
Decantation, centrifugation, filtration
442
Solid phase vehicle for labeled immunoassay (5)
Polystyrene tubes
Microtiter tubes
Glass or polystyrene beads
Magnetic beads
Cellulose membranes
443
Label for Labeled Immunoassay : DETECTION (3)
Enzyme = Spectrophotometer
Fluorescein dye = Fluorometer, flow cytometer, spectrophotometer
Radioisotopes = Gamma scintillation counter
444
- Cheap and readily available
- Ag or ab detection use
- Commonly used labels = Alkaline phosphatase (Bovine intestine), Horseradish peroxidase (Horseradish), B- galactosidase (E.coli)
Enzyme aim,unoassay or ELISA
445
Noncompetitive EIA
Indirect = detects abs , solid phase= ag, direct concentration proportion , label AHG
Direct = detects ag, solid phase= ab, direct concentration proportion
, label Ab against ag
Sandwich = detects ag, solid phase= ab, direct concentration proportion , label AHG
446
- Detects ag
- Solid phase = ab
- Label = ag
- INVERSE concentration proportion
Competitive EIA
447
- Detects ag
- Solid phase = Unattached abs
- Labels = Abs
- Direct concentration proportion
Immunozymetric
448
- Typically used label = FITC, Tetramethyrhodamine, Phycoerythrin, Europium, Lucifer yellow
- Direct = rgt is labeled ab and speciment is ag
- Indirect = rgt is ag and labeled ag and specimen is ab
Fluorescence Immunoassay
449
Most popular radio immunoassay label
I 125
450
- First type immunoassay developed
- Radiation hazard
- Forms: Non-competitive, comptetitive, immunoradiometric
Radioimmunoassay
451
Quantitate total IgE
Radioimmunosorbent assay (RIST)
452
Antigen specific IgE
Radioallergosorbent Test (RAST)
453
- Emission light caused by chemical reaction
- Labels = Luminol, Acridium esters, Ruthenium derivatives, Nitrophenyl oxalate
- For cardiac marker, hormones, Vit D level, total IgE
Chemiluminiscent Immunoassay
454
Unexpected fall of analyte concentrstion due to ag excess
Hook effect
455
- uses electrochemical compound
- Solid phase = magnetic beads
- Light measured by photomultiplier tube
Electro-chemilumiscence Immunoassay
456
Two types of Nucleic Acids
DNA = deoxyribose sugar, double stranded
RNA = ribose sugar, single stranded
457
Central Dogma of Life
Replication
Transcription
Translation
458
Hybridization techniques
Southern blot
Microarray technology
Fluorescent in situ hybridization
459
Amplification techniques
Target amplification = PCR, Transcription mediated amplification, Ligase chain reaction
Probe amplification = standard displacement amplification, cleavase/ invader technology
Signal amplification = branched DNA, Hybrid capture assays
Whole genome amplification
460
- Amplifies tiny quantities of nucleic acid up to detectable levels
- Reagents = combination freshly prepared reagents
PCR or Polymerase Chain Reaction
461
Reagents of PCR:
- medium to suspend reagents
Water
462
Reagent of PCR:
- maintains pH
Buffer
463
Reagent of PCR:
- cofactor to enzyme
MgCl2
464
Reagent of PCR:
- Building blocks of DNA
Nucleotide
465
Reagent of PCR:
- starting point
Fore primer and reverse primer
466
Reagent of PCR:
- stabilize temperature (from Thermus aquaticus)
Taq polymerase
467
Steps in PCR: (3)
Denaturation = heat to 95 degrees to separate dsDNA to single strands
Annealing = cool to 52 degrees from primers to bind to complimentary sequence on each DNA strands
Elongation = 72 degrees, heat-stable DNA polymerase binds to primer syntehsize new strand of DNA
468
- Measures multiple properties of cells suspended in a moving fluid medium
- Identify and enumeratevvarious cell population
Flow Cytometry Analysis
469
Laboratory tests for Syphilis Serology (2)
Direct test
Non- treponelmal test
470
Species of Treponema (4)
T. pallidum subsp pertenue = YAWS
T. pallidum subsp endemicum = BEJEL
T. carateum = PINTA
T. cuniculi = RABBIT
471
Physical process of contact and adhesions wherein aggregates form karger-size clusters called flocs or flakes
Flocculation
472
Clinical stages of Syphilis (4)
Primary = hard chancre, blood
Secondary = conylomata lata, blood
Latent = no s/s, blood and csf
Tertiary = Gummata’s lesion,csf
473
Detects anti-cardiolipin
Non-treponemmal test
474
- Quali or quanti slide flocculation test
- Spx: Serum and CSF
- Read microscopically
VDRL
475
VDRL requires serum inactivation (2)
Heat serum for 30 mins at 56 degreees
Use serum within 4 hours
476
Reagents for VDRL (3)
0.03% cardiolipin
0.9% cholesterol
0.21% lecithin
477
Gauge of needles for Hamilton syringe (VDRL)
Qualitative = 18g (60 + or - then 2 drops)
Quantitative = 19g (75 + or - then 2 drops) or 23g (100 + or - then 2 drops)
478
Antigen that stabilizes Ag and inactivates complement (RPR)
EDTA
Na2HPO4
Thimerosal
Charcoal
Choline chloride
479
RPR:
Place serum-ag mixture in a rotator for _____ min @ 100 rpm
8 min
100 rpm
480
RPR:
- Uses plastic-coated disposable card with ______ circles instead of glass slide
10-18 mm circles
481
RPR:
- Gauge no. of needles
- Drops of Ag suspension/ml
20 gauge
60 + or - 2 drops
482
Old to new world
Smallpox
483
New to old world
Syphilis
484
Treponemal tests for Syphilis (2)
T. plallidum Immobilization Test
FTA-Abs
485
- Trepnemal test for syphilis
- Specimen = Serum
- Reagent = Motile bacterial suspension
- Interpretation = POS >50% immobilized, NEG <50, DOUBTFUL 20-50%
T.pallidum Immobilization Test
486
- Treponemal test for syphilis
- Specimen = Serum
- Reagent = dead T.pallidum in slide (Nichol’s virulent strain)
- Label = FITC- AHG
- Sorbent = Reiter strain
- View under UV light
FTA-Abs
487
Agglutination Tests (4)
TP Hemagglutination
Microhemagglutination
Hemagglutination Treponemal Test for Syphilis
TP- Particle Agglutination
488
Agglutination Test:
- Reagent = Tanned SHeep RBC coated with Ag from Nichols strain
- Confirmatory test = Indirect hemagglutination
TP Hemagglutination or TPHA
489
Agglutination Test:
- Reagent = Formalinized tanned sheep rbc coated with ag from Nichol’s strain
- Performed in microtechnique
Microhemagglutination or (MHA) TP
490
Agglutination Test:
- Reagent = Glutaraldehyed- stabilized turkey RBCs
- Automated version of TPHA
Hemagglutination Treponemal Test for Syphilis
491
Agglutination test:
- Reagent = Gelatin particles (instead of RBC) sensitized with T.pallidum
- Indirect Agglutination Test
TP- Particle Agglutination
492
- Retrovirus containing RNA and Reverse Transcriptase
- Target cell = CD4+ T cells
HIV Serology
493
Type of HIV :
- Formerly Human T-cell lymphotropic virus type III, Lyphadenopathy- associated virus, AIDS- associated retrovirus
- Causative agent of AIDS in US and Europe
HIV - 1
494
Type of HIV:
- Endemic in West Africa
- Less pathogenic
- Lower rate of transmission
HIV - 2
495
3 major routes of HIV transmission
Intimate Sexual Contact
Parenteral from body fluid/blood
Perinatal from infected mother (Vertical transmission)
496
Responsible for binding to CD 4 receptor of T cells (HIV)
gp120
497
First antibody to appear (HIV)
Anti-p24
498
HIV:
- Screening test
ELISA
499
HIV:
- Confirmatory test
Western blot
500
- Positive = + at least 2 bands
- Bands = p24, gp41, gp120/160
Western blot (HIV)
501
HIV:
- Ratio of CD4:CD8
1:2 or 0.5:1
502
- CD4 count in AIDS
<200 ul
503
Confirmatory test for HIV in Philippines
RHiVDA or Rapid HIV Diagnostic Algorithm
504
HIV:
- Test used 5 days from initial contact of infective agent
NAT
505
HIV strains (2)
T-tropic X4) strain - HIV infecting T cells (lymphocyte strain)
M-tropic (R5) strain - HIV infecting both T cells and macrophage (monocyte strain)
506
HIV Transmission %
- Blood transfusion
- Sexual intercourse; receptive anal intercourse
90%
6-8%
507
Syphilis Serology
RPR - screening test
FTA - confirmatory
ELISA - either screening or confirmatory
508
HIV Test:
- Gold standard = Immunophenotyping w/ Flowcy
- HIV AIDS CD4 count = <200 cell/mm3
CD4 T cell Enumeration Test
509
Screening tests forHIV Antibody Detection (3) “E A D”
ELISA
Agglutination test
Dot- blot testing
510
Confirmatory test for HIV Antibody detection (2) “W I”
Western blot
Immunofluorescence
511
Window oeriod before antibody is detectable
P24 Antigen detection
512
Determine viral load and development of drug resistant strain
HIV NAT
513
Quantitative test for HIV Nucleic Acid
Viral Load Test
514
HIV test preferred method for infants, hildren younger than 18 months
PCR
515
HIV Generation
First = detects ab to HIV 1 only
Second = detects ab to HIV 1 and HIV 2
Third = detects HIV ab of different Ig class including IgM
Fourth = detects HIV 1 and HIV 2 ab and p24 antigen
516
HIV Structural Gene (3)
Gag or Group Antigen Gene
Pol or Polymerase
Env or envelope
517
HIV Structural Gene = Product
- p25, core proteins ( p6, p9, p17, p24)
Gag or Group Antigen Gene
518
Products of Pol/ Polymerase gene (4)
Reverse transcriptase (p66, p51) = transcribes RNA to DNA
Integrase (p31) = inserts viral DNA to host
Protease (p10) = cleaves protein precursors
RNase = slipts DNA to RNA again
519
Products of Env/ Envelope gene (3)
gp160 = cleaved to form gp120 and gp41
gp120 = binds to CD4 on T cells
gp41 = transmembrane protein
520
Markers of Hepatitis B infection (6)
HBsAg = active infx
HBeAg = high degree of infectivity
IgM Anti-HBc = current or recent infxn, core windor period
IgG Anti-HBc = lifelong marker
Anti-HBe = recovery markerv
Anti-HBs = immunity to Hepatitis; Protective marker: > or = to 10 miu/ml of serum
521
Markers of Hepatits A infxn (4)
IgM anti-HAV = incubation period and early phase
IgG anti-HAV = Immunity to Hepa A
Total anti-HAV = Immunity to Hepa A
HAV RNA = HAV in clinical, food, water samples
522
Other names of Hepatitis:
- Hepa A
- may be transmitted by clotting factors
Infectious hepatitis
523
Other names of Hepatitis:
- Hepa B
Serum Hepatitis
524
Complete HBV that causes infxn
Dane particle
525
Other names of Hepatitis:
- Hepa c
Non-A, Non-B hepatitis
Post transfusion hepatitis
526
- Increased ALT
- Positive Anti-HBc
Surrogate Test for HCV
527
Positive Anti-HCV
Specific test for HCV
528
Tests for Streptococcal Serology (3)
ASO
Anti-DNase B Test
Streptozyme Test
529
_____ fold rise in titer to be considered significant (Streptococcal serology)
4 fold
530
Streptococcal Serology:
- 5 in 1 test = slide agglutinating screening test
- Reagent = Sheep RBCs coated with streptococcal extracellular products
Streptozyme
531
Streptococcal serology:
- Latex agglutination test = indirect or passive agglutination
- Tube test = neutralization or inhibition
ASO or Anti- streptolysin O titer
532
ASO tube testing units used:
Todd units = streptolysin rgt istandard is used
UI = WHO international standard
Normal= <200 todd unit
533
- Detects Ab capable of preventing DNase from depolymerizing DNA
- Principle = Neutralization
- Reagent = DNA-metho green substrate
- Grading= 4+ unchange color (positive), 0 toal loss of color (negative)
Anti- DNase B
534
Kissing disease caused by EBV
Infectious Mononucleosis
535
Atypical lymphocytes in EBV infxn
Downey cells
536
Infectious Mononucleosis Serology:
- Cross react with a group of similar antigen
- IgM usually appears during acute phase of ifxn
Heterophile Antibody
537
Heterophile Ab of IM:
- React with
- Absorbed by
- Not absorbed by
- React with = Horse, Ox, sheep rbcs
- Absorbed by = Beef rbcs
- Not absorbed by = Guinea pig kidney cells
538
IM Serological Tests (3)
Paul-Bunnel Screening Test
Davidsohn Differential Test
Monospot test
539
- IM serologic test
- Hemagglutination, detect heterophile ab
- Reacts with sheep rbc
- Normal titer: < or = to 56
Paul Bennel Screening Test
540
- IM serologic test
- Differentiates HA associated with IM, Serum sickness or Forssmann Ag
- Agglutination = Sheep rbcs
- Absorbed by = Guinea pic and Beef rbc
- Perform if Paul Bennel Screening test result is > 56
Davidsohn Differential Test
541
- IM serologic test
- Rapid differential slide test
- Requires absorption of px serum
- Horse rbc is agglutinated by heterophile ab of IM
Monospot test
542
Detects ab to Salmonella, Brucella, Tularemia
Widal test
543
Salmonella Serology:
- Clinical significant titer
> or = to 160
544
Antigens in Salmonella Serology (3)
O antigen = LPS
H antigen = Protein
K or Vi antigen = Polysaccharide/ capsular or virulent
545
Salmonella serology:
- Carrier specimen
Fluid from gallbladder (1 yr.)
546
Causes spotted fever and typhus
Rickettsia
547
- Test for detection of ab in rickettsia
- Four fold rise in titer or 1:160 is significant
Weil Felix Test
548
Antigens in Rickettsia serology (3)
OX-K
OX-2
OX-19
549
Ricketssia Serology: ORGANISM
- Epidemic typhus
- OX-19 (+)
R. prowazekii
550
Ricketssia Serology: ORGANISM
- Rocky mountain spotted fever
- OX-19 or OX-2 (+)
R. rickettsia
551
Ricketssia Serology: ORGANISM
- Scrub typhus
- OX-K (+)
R. tsutsugamushi
552
- Stool antigen test
- With endocscopy or No endoscopy
H. pylori serology
553
H. pylori serology:
- With endoscopy (3)
H. pylori culture
Histological exam
Urease biopsy test
554
H.pylori serology:
- No endoscopy (4)
Urea breath test
Enzyme immunoassay for bacterial ag in STOOL
Molecular test
Serum EIA
555
- Associated with cold agglutinins
- Auto p anti-I (blood banking)
M. pneumonia serologic test
556
Serologic test for ______:
- Thick smear = quantitation
- Thin smear = identification
Malaria
557
Immunochromatography for Malaria (2)
OptiMAL Assay
MalaQuick Stanby Marlarial test
558
Immunochromatography for Malaria:
- detects parasitic LDH (100-200 parasites/ul blood)
- detects variable parasite
- distinguish bet. spp through detection of different isoforms of PLDH
OptiMal Assay
559
Immunochromatography for Malaria:
- Detects P. falciparum Histidine Rich Protein (HRP)- 2 Antigen
MalaQuick Standby Test for Malaria
560
T or F:
H. capsulatum is a fungi.
True
561
Serological test for Histoplasma:
- 2 precipitin band of diagnostic significance
H line = most specific, found up to 2 yrs after recovery “HUMANA”
M line = found in px with active infx or past infxn or px who had recent skin test “MASASAKTAN KA PA”
562
Serological tests for Influenza (2)
Hemagglutinin = required for entry of virus (H1 to H18)
Neuramidase = for release of virus from cells (N1 to N11)
563
Mutations of Influenza (2)
Antigenic shift = occurs every 10 yrs, sudden in onset
Drift = occur at the site if the virus as it replicates, pre-existing abs
564
Most common cause of congenital infection
CMV or Cytomegalovirus
565
- Uses Frei test for Lymphogranuloma Vinerium
Chlamydia trachomatis
566
- Agent = Toxoplasma gondii
- Utilize Sabin-feldman dye test
Toxoplasmosis
567
- Utilizes Casoni skin test
Echinococcosis
