Module 1

Question 1

Immunology

Definition

Answer 1

The study of the immune system

Question 2

Immune system

Answer 2

must recognize your body as “self” and the invader as foreign
Many systems work together to protect the body
Good response vs bad response
How we can manipulate or help the body (vaccines)

Question 3

First line of defense in the immune system

Answer 3

unbroken skin and mucosal membrane secretions

Question 4

Ways to classify immunity

Answer 4

natural vs acquired
humoral vs cellular
passive vs active

Question 5

Natural immunity

Answer 5

Your inborn resistance (phagocytes, complement, an acute inflammatory response)

Question 6

Complement

Answer 6

inert substance in the blood capable of binding certain antibodies helping to destroy the foreign substance through lysis

Question 7

When does CRP elevate

Answer 7

before disease. good warning sign!

Question 8

Acquired or Adaptive Immunity

Answer 8

Allows the body to recognize, remember and respond to a stimulus (antigen)
Whenever T-cell and B-cells are activated, some become memory cels

Question 9

Humoral Immunity

Answer 9

Acquired if the antibodies are formed by the host or received from another source
Mode of action is antibodies in the serum
Cells: B-lymphs
Mechanism: antibody-mediated
Purpose: primary defense against bacterial infection

Question 10

Cellular Immunity

Answer 10

Delayed hypersensitivity
Moderated by the link between T-lymphs and phagocytes: T-cells recognize when an antigen is present on a phagocyte
Mode of action: cell-to-cell contact or soluble products secreted by cells
Cell type: T-lymphs
Mechanism: cell-mediated
Purpose: Defense against viral and fungal infections, tumor antigens and graft rejections

Question 11

Passive Immunity

Answer 11

May be naturally occurring or acquired artificially
Natural: passes across the placenta during pregnancy but decreases after birth
Artificial: when antibody-containing serum is administered- Rhogam or hepatitis immune globulin
Not permanent - titers drop over time

Question 12

Active immunity

Answer 12

Immune response that is triggered by infection (natural active immunity). Stronger than artificial immunity
Immune response that is triggered by vaccination (artificial active immunity). Intended to be permanent or may require a booster

Question 13

Vaccines

Answer 13

Suspensions of antigenic material of animal or plant origin
Should stimulate antibody production without clinical symptoms of disease in a health (immunocompetent) person
Should cause permanent memory
May be composed of living suspensions of weak or attenuated cells or viruses
May contain only a portion of the infectious agent

Question 14

Hypersensitivity Reactions

Answer 14

Bad condition of the body tissues caused by antigenic stimulation
Two classifications: delayed hypersensitivity reaction or immediate hypersensitivity reaction

Question 15

Delayed Hypersensitivity Reaction

Answer 15

Often used synonymously with cell-mediated immunity
Refers to the slow appearance of a secondary response in the skin

Question 16

Immediate Hypersensitivity

Answer 16

Mediated by IgE immunoglobulins due to allergens

Question 17

Self-tolerance

Answer 17

Exists when the immune cells and other body cells exist peacefully together

Question 18

What government agency is primarily responsible for safeguards and regulations to ensure a safe and healthful workplace through the United States

Answer 18

Occupational Safety and Health Administration (OHSA)

Question 19

Standard Precautions

Answer 19

Treating all specimens as if they are infectious
Assuming that every direct contact with a body fluid in infectious

Question 20

The CDC’s Bloodborne Pathogen Requirement mandates

Answer 20

Education and training of all healthcare workers in Standard Precautions

Question 21

The single most common source of human immunodeficiency virus in the occupational setting is

Answer 21

Blood

Question 22

When using gloves for phlebotomy or blood specimen processing, laboratory staff should

Answer 22

wash hands after removing gloves

Question 23

Gloves for medical use may be

Answer 23

sterile or nonsterile

Question 24

Diluted bleach for disinfecting work surfaces, equipment, and spills should be poepared daily by preparing a __ dilution of household bleach. This dilution requires ___ mL of bleach diluted to 100 mL with H2O

Answer 24

1:10
10

Question 25

Infectious waste must be discarded into containers with what features

Answer 25

Markled with biohazard has standard biohazard symbol orange, orange and black, or red

Question 26

Clinical laboratory personnel need to have demonstratable immuity to

Answer 26

Rubella and Hepatitis B

Question 27

What is an antigen

Answer 27

Any substance capable of stimulating antibody formation and has the ability to bind to that antibody or t-cell receptor, but may not be able to cause an initial immune response

Question 28

Antigen examples

Answer 28

viruses bacteria fungus parasite portion of a product- capsule, endotoxic, cell wall tissue or cells from another individual- organ/bone marrow transplant or blood transfusion

Question 29

Antigen vs. immunogen

Answer 29

All immunogens are antigens, but not all antigens are immunogens Immunogens trigger an adaptive immune response by inducing the formation of antibodies or sensitized T-cells Immunogens react with specific antibodies or sensitized T-cells

Question 30

Antigenic Determinants

Answer 30

Epitope Epitope is location that determines antigen

Question 31

Chemical nature of antigens

Answer 31

Usually proteins or large polysaccharides Rarely lipids Proteins are excellent antigens because of the high molecular weight and structural complexity Lipids are poor antigens unless they are linked to a protein or large polysaccharides

Question 32

Physical nature of antigens

Answer 32

Foreignness- must be recognized as non-self Degradability- repidly destroyed becayse they are foreign; must be sufficient in number to elicit an immune response Molecular weight- the higher the molecular weight; the better the molecule will function as an antigen Structural stability- if unstable (lipid) is will be a poor antigen Complexity- the more complex; the more effective it will be

Question 33

Antibodies

Answer 33

speficifc glycoproteins usually referred to as immunoglobulins can be found in blood plasma and many body fluids such as tears, saliva and colostrum

Question 34

Antibody primary function

Answer 34

to combine with an antigen - this may be sufficient to neutralize bacterial toxins or some viruses May combine with complement to dispose of larger antigens like bacteria

Question 35

Antibody structure

Answer 35

All have a common basic polypeptide structure that has a 3-dimensional configuration Is a protein 4-chain structure based on pairs of heavy and light chains. Area that holds the antigen is called the variable region or Fab region (fragment antibody) The stem lets the Ab bind to complement or macrophages. It is called the constant region or Fc region (fragment constant)

Question 36

Immunoglobulins concentration from greatest to least

Answer 36

IgG, IgA, IgM, IgE, and IgD G A M E D

Question 37

IgG

Answer 37

70-75% Diffuses into extravascular spaces where it neutralizes toxins or binds to microorganisms Can cross the placenta When IgG complexes are formed, complement can be activated IgG1, IgG2, IgG3, and IgG4 Monomer

Question 38

IgA

Answer 38

15-20% predominant in secretions such as tears, saliva, colostrum, milk and intestinal secretions alpha1 and alpha 2 subclasses. Secretory IgA protects against microorganisms a monomer (1 Y) in plasma a dimer (2 Y) when secreted

Question 39

J chain

Answer 39

joins antibody chains together

Question 40

IgM

Answer 40

10% confirmed to the intravascular pool since its so large produced first in an immune response and confined to blood has five pairs of heavy chains; therefore, IgM is a pentamer (has 5 Y's)

Question 41

IgE

Answer 41

trace plasma found in blood less than 1-2% mediates some types of hypersensitivity (allergic reactions and anaphylaxis) generally responsible for an individual's immunity to invading parasites monomer binds strongly to a receptor on mast cells and basophils and mediates the release of histamines and heparin from these cells

Question 42

IgD

Answer 42

Less than 1% found in very low concentrations in plasma Primarily a celll membrane immunoglobulin found on the surface of B-lymphocytes in association with IgM IgD is a monomer

Question 43

Immunoglobulin monomers

Answer 43

IgG IgE IgD IgA in plasma

Question 44

Immunoglobulin dimers

Answer 44

Secretory IgA

Question 45

Immunoglobulin pentamer

Answer 45

IgM

Question 46

Antibody synthesis

Answer 46

Production of antibodies is induced when the host's immune system comes into contact with a foreign antigenic substance and reacts to the substance Immune response can be cell-mediated or humoral (antibody)

Question 47

Primary antibody response

Answer 47

lag log plateau decline IgM and IgG primarily form

Question 48

lag

Answer 48

no antibody is detectable

Question 49

log

Answer 49

antibody titer rises exponentially

Question 50

plateau

Answer 50

the antibody titer stabilizes

Question 51

decline

Answer 51

the antibody used and decreases- catabolized

Question 52

Secondary Response

Answer 52

subsequent exposure ti the same antigenic stimulus produces an antibody response that differs from primary response by: shorter lag, longer plateau and a more gradual decline primarily IgG antibody levels attain a higher titer referred to as anamnestic response or IgG response

Question 53

Antibody specificity and cross-reactivity

Answer 53

antigen-antibody reactions can show a high level of specificity if molecules are genetically similar, it can cause an immune response, even if you weren't allergic to it. Ie heterophile antibodies produced in mononucleosis cross-react with Reagin antibodies produced in syphilis