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Immun PracTest 3
Practice for Immunology test 3 at DelTech Owens campus
| Question | Answer |
|---|---|
| Unlabeled immunoassays rely on the binding sites of BOTH __ and __. | antibody and antigen |
| If the antigen in an unlabeled immunoassay is soluble, the reaction is called ? | precipitation |
| If the antigen in an unlabeled immunoassay is a particulate, the reaction is called ? | agglutination |
| When an antigen and an antibody meet at appropriate concentrations, large __ __ can form. | cross-linked structures |
| Unlabeled immunoassays that rely on precipitation or agglutination have (high or low?) accuracy. | low |
| How can we increase the sensitivity of unlabeled immunoassays? | optics (nephelometry and tubidometry) |
| __ is performed by measuring the turbidity in a sample by passing light through the sample at an angle. | nephelometry |
| __ is performed by measuring the intensity of a beam of light as it passes straight through a sample. | turbidometry |
| What is the difference between nephelometry and turbidometry? | In nephelometry the intensity of the scattered light is measured as leaves the sample at an angle. In turbidimetry, the intensity of light transmitted straight through the sample is measured. |
| The strength of the bond between one FAB region on an antibody with one epitope on an antigen is called ? | affinity |
| The higher the affinity, the higher the amount of the antibody and antigen that will be __ together. | complexed |
| Higher affinity means (high or lower?) sensitivity of the reaction in the test. | higher (because less of the antigen and antibody will be in an UNcomplexed form) |
| The more binding sites between an antigen and an antibody, the higher the ? | avidity |
| Avidity is the number of __ __ times the affinity. | binding sites |
| Steric hindrance can __ avidity. | lower |
| Large complexes are formed when antigens and antibodies meet at a concentration where ? | the number of paratopes approximately equals the number of epitopes |
| When there is too much antibody for precipitation or agglutination to take place during an unlabeled immunoassay, the area between the antibody and the antigen is called a ? | prozone |
| When the ratio between antibody and antigen is just right, the area between them is called the area of ? | equivalence |
| In an area of equivalence, the number of __ approximately equals the number of __. | paratopes equal the number of epitopes |
| When the amount of antibody is too low in an unlabeled immunoassay test, the area between the antibody and the antigen is called the ? | postzone |
| The most visible precipitation would occur in (equivalence, prozone, postzone?) | equivalence |
| You would get no precipitation in a (equivelence, prozone, postzone?) reaction. | postzone |
| You would get little to no precipitation in a (equivalence, prozone, postzone?) reaction. | prozone |
| If no precipitation occurs during an unlabeled immunoassay, this suggests the patient ? | did not have enough of the antibody to create a visible reaction. |
| If a prozone reaction occurs, the patient's serum can be __ and tested again to reach equivalence. | diluted |
| If a postzone reaction occurs, the patient's blood can be drawn again to allow an increase in __ to bring the reaction to the zone of equivalence. | titer |
| In a prozone or postzone reaction during an unlabeled immunoassay test, the patient would be (positive or negative?) for the antigen being tested. | negative |
| Why would you dilute the sample and retest if your first result is prozone in an immunoassay? | Prozone means the patient had too many antibodies to reach equivalence. Dilution corrects this by lowering the concentration of antibodies. |
| What are the advantages of precipitation techniques? | They are very easy. |
| What are the disadvantages of precipitation techniques? | They are the least sensitive serological techniques. |
| Radial immunodiffusion is a (single or double?)-diffusion technique | single-diffusion |
| Quchterlony is a (single or double?) diffusion technique. | double-diffusion |
| Double-diffusion means that both the __ and the __ diffuse through the agarose. | antibody and antigen |
| A precipitin line forms where diffusion brings the relative concentrations of antibody and antigen to ? | equivalence |
| What is the precipitin line formed from? | The lattice structure of the antibody/antigen complexes |
| The Ouchterlony test allows for determination of antigenic relatedness of an unknown __ __ with a known __. | test material with a known antigen |
| What are the 3 possible results of an Ouchterlony test? | 1. identity 2. partial identity 3. nonidentity |
| Is the Ouchterlony test a quantitative or qualitative test procedure? | qualitative |
| During the Ouchterlony test procedure, an increasing amount of __ is added to a constant amount of __ in solution. | antigen, antibody : Use the simulator at http://jeeves.mmg.uci.edu/immunology/Ouchterlony/ouchterlony.html |
| The Ouchterlony test compares the __ of the antigens. | relatedness |
| When the 2 different antigen preparations contain the same antigen in an Ouchterlony test, a line of __ will form. | identity |
| The arc shape of the identity line in the Ouchterlony test is the result of ? | the circular spread of the diffusing molecules from each well and the reagents reaching each other at equilibrium, forming an arc. |
| In an Ouchterlony test, if the precipitin line curves downward (like a frown) this forms a line of ? | identity |
| In an Ouchterlony test, if the precipitin lines cross each other (like an X) this forms a line of ? | nonidentity |
| In an Ouchterlony test, if one of the precipitin lines is longer than the other, this forms a line of ? | partial identity See more at http://amrita.vlab.co.in/?sub=3&brch=70&sim=689&cnt=1 |
| A line of partial identity in an Ouchterlony test means that one of the molecules has an additional __ so that a spur has formed on the precipitin line. | epitope |
| Relative concentrations of antigens can be determined in a (double or single?)-gel precipition test. | double |
| The further the precipitin line is from the well where the antigens and antibodies have been placed in a double diffusion test, the __ the concentration of either reagent. | lower |
| Radial immunodiffusion is a (quantitative or qualitative?) immunoprecipitation technique? | quantitative |
| Radial immunodiffusion is a (single or double?) immunodiffusion technique. | single |
| In a double diffusion test, the antigen with the higher concentration would form a precipitin line that is (closer to or further from?) the antibody well. | closer to |
| During radial immunodiffusion, (different or the same?) concentrations of the antigen diffuse into the gel. | different |
| The __ of the precipitin line is related to the concentration of the antigen. | diameter |
| How many concentrations of the antigen are used to produce a standard curve in Radial immunodiffusion? | 3 |
| What are the 2 methods for quantitating the results of Radial immunodiffusion? | Fahey and Mancini |
| What 4 levels does Radial immunodiffusion measure? | 1. IgG 2. IgM 3. IgA 4. complement |
| Which method of optical analysis measures the amount of light that is lost when it has been shined directly through a solution? | turbidometry |
| Which method of optical analysis measures the scattered light that has been shined through a solution at an angle? (10-90 degrees) | nephalometry |
| Which method of optical analysis is more sensitive: turbidometry or nephalometry? | nephalometry |
| Which 6 immunoglobulin concentrations are measured using nephalometry? | 1. IgG 2. IgM 3. IgA 4. IgE 5. kappa light 6. lambda light |
| Agglutination is (more or less?) sensitive than precipitation? | more |
| Why is agglutination a more sensitive test than those employing precipitation techniques? | the larger antigen particles enhance visualization |
| The coating of red blood cells or inserting of latex beads with soluble antigens is part of a process known as ? | passive agglutination |
| Agglutination testing is done with 2 particles that have an electric charge and that naturally (attract or repulse?) one another. | repulse |
| What pulls the particles together during an agglutination test? | antibodies |
| During an agglutination reaction, the stronger the force of the antibody that brings the particles together, the stronger they try to electrically __ one another. | repel |
| Which antibody works better in agglutination tests? IgM or IgG? | IgM |
| Which antibody has binding sites with the widest reach? | IgM |
| Why is the pH of the particles in an agglutination reaction important? | pH affects the amount of charge |
| If the charge of an agglutination test decreases, the apparent titer ? | increases |
| What affect would the use of low ionic strength media have on an agglutination test? | It would improve the binding of the charged particles because the repelling forces would be reduced. |
| Using a media with increased viscosity would have what affect on an agglutination test? | It would improve the binding of the charged particles. |
| What temperature is best when running an agglutination test using IgM? | 37 Celsius |
| What temperature is best when running an agglutination test using IgG? | between 4 and 27 Celsius |
| One way to stengthen the binding of charged particles during an agglutination test is to treat red cells with __ to decrease surface charge. | enzymes |
| Agitation or centrifugation of the charged particles __ the interaction of the particles during an agglutination test. | increases |
| Some IgG agglutination tests may __ because the electrical repulsion of the particles is too great. | fail |
| What 3 methods can be used to improve the binding of charged particles during an agglutination test? | 1. use LISS (low ionic strength media) 2. use media with higher viscosity 3. control temperature (IgM best temp 4-27 C)(IgG best temp is 37 C) |
| How can you overcome a failure of an agglutination test due to the repulsive forces being too strong for the antibodies to overcome? | Add antihuman antibodies (an antibody to the antibody that is already present) |
| By adding an antihuman antibody to an agglutination test, you are __ the reach of the IgG antibodies. | increasing |
| When an antihuman antibody is added to an agglutination test, it binds to __, forming a larger chain. | IgG |
| Which kind of antibody is most likely to fail to overcome the repulsive forces at play during an agglutination test? | IgG (add antihuman antibody to fix this) |
| What are the 5 kinds of agglutination tests? | 1. direct 2. passive 3. reverse passive 4. hemagglutination 5. agglutination inhibition assay |
| What do you call it when the antigen is not normally part of the particle during an agglutination test? | passive agglutination |
| What do you call it when the antigen is naturally part of the particle during an agglutination test? | active agglutination |
| Agglutination tests using red blood cells are called ? | hemagglutination tests |
| When the antibody is attached to the particle during an agglutination test and not to the antigen, this is called ? | reverse passive agglutination |
| What kind of test checks for the presence of A,B, or C antibodies on a person's RBCs? | Direct antiglobulin test (DAT) |
| Which kind of test checks for the presence of an antibody in a patient or for blood group AGS on a patient's cells? | Indirect antiglobulin test (IAT) |
| A competition between kit-supplied particle antigens and patient antigens for the supplied antibody is used during a ? | agglutination inhibition assay |
| How can the sensitivity of precipitation and agglutination assays be increased? | With 1. nephalometry 2. turbidometry |
| What is the PETINA method used for? | Therapeutic drug monitoring |
| What is therapeutic drug monitoring used for? | To determine serum concentrations achieved with administration of a therapeutic drug. |
| What does PETINA stand for? | particle-enhanced turbidometric inhibition assay |
| The drug that comes with a PETINA kit inhibits __ of the particles by the antibody. | cross-linking |
| The drug in a PETINA kit increases the __ of the solution once the particles have been added. | turbidity |
| What does PACIA stand for? | particle-counting immunoassay |
| What does PACIA measure? | residual nonagglutinating particles after an agglutination reaction |
| Unlabeled immunoassays can be used when the concentrations of the reactants are high enough to be ? | seen |
| Any immunoassay that involves physical separation of antibody-bound antigens from the remaining free antigens is called ? | Heterogeneous |
| Any immunoassay that does not involve physical separation of antibody-bound antigen from antigen molecules that remain free is called ? | Homogeneous |
| A radioimmunoassay is a homogenous or heterogeneous assay? | Heterogeneous |
| ELISA stands for ? | enzyme linked immunosorbant assays |
| FIA stands for ? | Fluorescent immunoassay |
| A radioactive isotope used as a tracer is called a ? | radiolabel |
| Name 3 types of labeled immunoassays. | 1. chemiluminescent labels 2. colloid particles 3. optical immunoassays |
| What kind of labeled immunoassays are detected in gamma or liquid scintillation counters? | radiolabel |
| Enzyme labels can be detected by the conversion of a substrate by the enzyme. This will produce what 4 things? | 1. color change 2. fluorescent compound 3. flash of light 4. change in optical reflection |
| Enzyme labels that produce a color change are measured how? | spectrophotometrically |
| Fluorescent compounds that are used as enzyme labels are measured ? | fluorimetrically |
| Chemiluminescence of certain enzyme labels are measured with a ? | luminometer or photomultiplier tube |
| Changes in optical reflection in optical immunoassays that use enzyme labels are measured with ? | the eye |
| What type of immunoassay uses large colored colloid particles attached to the antibody or antigen in a way that does not cause steric hindrance? | colloid immunoassay |
| Colloid immunoassays are useful in __ __ __ testing. | point of care |
| Colloid immunoassays are useful in __ test kits. | pregnancy |
| Colloid immunoassays are detected by the __ after separation in a process called immunochromatography. | eye |
| Colloid immunoassays do not require __, which makes them useful for point of care testing and means they can be seen by the naked eye. | instrumentation |
| Heterogeneous immunoassays involve a __ of bound from free. | separation |
| Homogeneous immunoassays (do or do not?) require a separation of bound from free? | do not |
| The __ __ complex can be directly detected using a heterogenous assay. | antigen antibody |
| A 2nd __ antibody can be utilized in a heterogeneous assay. | anti-immunoglobulin |
| The antigen or antibody can be captured by a __ to a solid-phase and detected by a 2nd molecule during a heterogenous assay. | capture-molecule |
| An inhibition step can be performed where labeled and unlabeled reactants __ during a heterogeneous assay. | compete |
| Which kind of heterogenous assay uses labeled antibody binding to an antigen OR a labeled antigen binding to an antibody? | direct immunoassay |
| Which kind of heterogenous assay uses an unlabeled antigen, unlabeled antibody, and a labeled immunoglobulin? | indirect immunoassay |
| An indirect immunoassay detects the reaction of the initial __ and __ complex. | antibody and antigen |
| What are direct immunoassays commonly used for? | To detect an antigen in a cell preparation or biopsy sample. |
| What are indirect immunoassays commonly used for? | To measure a patient's antibody titer to a known antigen. |
| Why was the indirect immunoassay developed? | It would be impractical if every patient's immunoglobulins had to be purified and labeled before every assay for a disease. The test would also be less sensitive. |
| Anti-human immunoglobulins can be used to detect what 5 things? | 1. all immunoglobulins 2. just IgM 3. just IgG 4. just IgE 5. any label |
| An indirect anti-human immunoglobulin test for IgM (class specific) can be used to detect an __ infection. | acute |
| An indirect anti-human immunoglobulin test for IgG (class specific) can be used to determine a patient's ? | immune status |
| An indirect anti-human immunoglobulin test for IgE (class specific) could be used to diagnose an __. | allergy |
| What kind of heterogenous immunoassay can capture an antigen between molecules of antibody? | sandwich or capture immunoassay |
| During a sandwich/capture immunoassay, one antibody __ the antigen while the other is labeled and helps us __ the reaction. | captures, visualize |
| Sandwich immunoassays are commonly performed on disposable ? | membrane cassettes |
| A colloid-labeled immunochromatographic sandwich assay uses the separating properties of __ to facilitate a capture or colloid assay. | chromatography |
| Can sandwich/capture immunoassays be used to detect specific antigens? | yes |
| If 2 antibodies are used during a sandwich/capture immunoassay, it will increase the assay's __. | specificity |
| What factor could give a false positive on a sandwich/capture immunoassay? | Rheumatoid |
| When would you use a competetive assay instead of a sandwich/capture assay? | 1. antigen is small and only has one epitope 2. when binding to multiple epitopes would create steric hindrance |
| What is steric hindrance? | 1. when size or shape of the molecule interferes with the interaction 2. when the bulk of the molecule is in the way of the reaction (hindrance) |
| 2 reasons you might use a competetive assay include ? | 1. measure total homocysteine 2. measure anti-hepatitis A antibodies |
| What sort of enzyme immunoassay uses multiple antibodies and antigens and tests for HIV? | Western Blot |
| What kind of test lets the test kit analyte compete for limited reagents with the analyte in the patient's sample? | competetive assay |
| What type of heterogeneous assay is used to diagnose Hepatitis C? | RIBA (Recombinant Immunoblot) |
| A RIBA assay differs from a Western Blot assay in how the __ are placed on the strip. | antigens |
| This heterogeneous assay enables analysis of individually labeled cells or particles. | flow cytometry |
| Flow cytometry is commonly used for __ ratio analysis in HIV patients. | CD4/CD8 |
| Flow cytometry is performed by a direct __ assay. | immunofluorescent |
| One kind of heterogeneous assay that is used in cases where several assays should be performed and is an adaption of flow cytometry is called ? | multiplexed fluorescent microbead assay |
| The multiplexed fluorescent microbead assay uses color-coded beads with a discrete fluroescent __ __ associated with a particular surface antigen. | color code |
| A fluorescently labeled __ __ is added when running a multiplexed fluorescent microbead assay. | antihuman immunoglobulin |
| In multiplexed fluorescent microbead assays, a laser is used to excite the bead's ? | fluorochromes |
| What kind of label is used most often in modern immunoassays? | enzymes |
| 2 of the best kinds of enzymes used in an enzyme immunoassay are ? | 1. horseradish peroxidase 2. alkaline phosphate |
| 3 less commonly used enzymes in an enzyme immunoassay are ? | 1. glucose oxidase 2. B-galactosidase 3. glucose-6-phosphate dehydrogenase |
| The results of optical enzyme immunoassays can be seen based on the property of the __ __ of the reaction. | solid phase |
| Optical enzyme immunoassays result in a change of color of the light that is reflected from a solid-phase polymer membrane once the antigen, antibody, and the converted substrate are all ? | bound |
| Fluorescent immunoassay are often used for direct testing on ? | tissues and cells |
| Fluorescent immunoassays are often used for indirect immunoassays for __ and __ __ testing. | autoimmunity, infectious disease |
| Fluorescent immunoassays are often used for flow cytometry and __ assays. | multiplex |
| The fluorochrome most often used in fluorescent immunoassays is apple green and called ? | fluorescein isothiocyanate (FITC) |
| What kind of immunoassay uses acridinium-labeled antibodies or antigen conjugates? | Chemiluminiscent assays |
| Colloid immunochromatography is a labeled immunoassay whose results can be read without any ? | training |
| What color of vacutainer tube top must be used when running homogenous assays on a patient's blood? | red (no EDTA or heparin tubes) |
| Name 3 substances that may exist in a patient's body that could interfere with a homogeneous assay. | 1. rheumatoid factor (RF) 2. heterophilic antibodies 3. human antimouse antibody (HAMA) |
| Antibodies induced by external antigens are called ? | heterophilic antibodies |
| Rheumatoid factor is the antibody to the FC region of the __ immunoglobulin. | IgG |
| Rheumatoid factor is usually (but not always) of what class of antibody? | IgM |
| When running a capture (homogeneous assay), rheumatoid factor can bind to the FC region of the __ immunoglobulin. | capture |
| Rheumatoid factor can cause a false-__ reaction during a capture assay unless it is controlled for. | positive |
| How can you correct for rheumatoid factor when running a capture assay? | Add IgG that does not react to the test antigen can block rheumatoid factor |
| Human heterophilic antibodies may be present in people who work with ? | animals |
| Human heterophilic antibodies can cause false-positive reactions in __ __ __ immunoassays. | sandwich antigen capture |
| How can you minimize the effect of human heterophilic antibodies on an immunoassay? | low-affinity antibodies |
| How can you compensate for the existence of human antimouse antibodies? | add mouse immunoglobulins that don't react with the antigen |
| How does someone develop human antimouse antibodies? | Treat them with therapeutic or diagnostic mouse monoclonal antibodies |
| Immune reactions that are overtly injurious to the host are called ? | hypersensitivity reactions |
| What do we call the system of classification for hypersensitivity reactions? | Gel and Coombs |
| Type 1 hypersensitivity reactions are due to __ mediated degranulation of __ cells. | IgE, mast (basophils are also involved) |
| Type 2 hypersensitivity reactions are due to cytotoxicity caused by __ cell surface reactions and __ activation. | antibody-mediated, complement |
| Type 3 hypersensitivity reactions are __ __ mediated and involve __ activation. | immune complex, complement |
| Type 4 hypersensitivity reactions are cell mediated reactions that involve sensitized __ cells and activated __. | T cells, macrophages |
| Hemolytic anemia and HDFN are examples of type __ hypersensitivity reactions. | 2 |
| Contact dermatitis is an example of type __ hypersensitivity reactions. | 4 |
| Arthus reactions are an example of type __ hypersensitivity reactions. | 3 |
| Asthma and hay fever are examples of type __ hypersensitivity reactions. | 1 |
| Which 2 classes of hypersensitivity reactions involve allergies? | 1 and 4 |
| Of the 2 classes of hypersensitivity reactions that involve allergies, which causes immediate reactions? | Type 1 |
| Type 1 hypersensitivity reactions can take how long to show symptoms? | 2-30 mins |
| Type 2 hypersensitivity reactions can take as long as __ to show symptoms. | 5-8 hours |
| Type 3 hypersensitivity reactions can take as long as __ to show symptoms. | 2-8 hours |
| Of the 2 classes of hypersensitivity reactions that involve allergies, which can cause reactions as much as 72 hours after exposure? | Type 4 |
| Type 4 hypersensitivity reactions can take as long as (full range)? | 24-72 hours |
| In type I hypersensitivity reactions, T helper cells can produce cytokines that cause a class switch to the __ isotype. | IgE |
| Harmless antigens that can stimulate an IgE response are called ? | allergens |
| Type I hypersensitivity reactions are designed to drive out potential __ pathogens or prevent their entry. | parasitic |
| How could type I hypersensitivity reactions remove or prevent parasites? | 1. clearing the gastrointestinal tract (vomit and diarrhea) 2. contraction blocks airways 3. increase fluids and blood flow (allows WBCs greater access) |
| Type I hypersensitivity reactions never occur during the __ exposure. | first |
| What are the 3 phases of allergic/hypersensitivity I reactions? | 1. sensitization 2. activation 3. effector |
| Different molecular mechanisms activate at different times in the __ cells. | mast |
| Mast cells and basophils degranulate during which phase of a hypersensitivity type I reaction? | early part of the effector phase |
| What 5 things are released into the body during the early part of the effector phase of a hypersensitivity type I reaction? | 1. histamines 2. prostaglandins 3. eosinophil chemotaxins 4. serotonin 5. proteases |
| The later part of the effector phase during a type I hypersensitivity reaction involves synthesis and secretion of __ and __ and __. | cytokines, chemokines, leukotrienes |
| The effector phase of a type I hypersensitivity reaction has 2 parts: an early phase and a late phase. The most severe clinical manifestations of type I hypersensitivity happen during which phase? | early phase |
| Late phase type I hypersensitivity reactions play a role in more chronic and serious manifestations, like ? | chronic asthma |
| During a type I hypersensitivity reaction, an allergen can enter fluid circulation throughout the body and activate mast cells in blood vessels at __ sites. | multiple |
| What happens during systemic anaphylaxis? (Type I hypersensitivity) | 1. blood vessel permeability increases 2. smooth muscle contraction 3. edema of upper airway can cause asphyxia |
| What can relieve the symptoms of systemic anaphylaxis? | epinephrine |
| Everyday allergens that can cause systemic anaphylaxis include? | 1. bee and wasp venom 2. peanuts 3. shell fish 4. antibiotics (like penicillin) |
| Allergens that cause systemic anaphylaxis can activate IgE coated mast cells and basophils and generate a __ response. | systemic |
| The severity of type I hypersensitivity reactions depends on levels of allergen-specific __. | IgE |
| One way of testing the severity of a type I hypersensitivity reaction is with a __ test. | RID |
| Type I hypersensitivity can affect what 2 tracts in the body? | 1. respiratory 2. digestive |
| Type I hypersensitivity reactions can be local or ? | systemic |
| What affects the severity of a type I hypersensitivity reaction? | 1. IgE levels 2. amount of allergen 3. the site of allergen introduction 4. the route the allergen takes |
| Two reasons some people may be severely allergic to allergens while others are not is due to __. | 1. inherited genetics (MHC haplotype and Th2 response) 2. higher levels of IgE |
| Severe IgE response is normally a reaction designed to protect us against ? | parasites |
| Areas of the body that are most sensitive to allergens are also likely entry points for parasites. Name 4 of these sites. | 1. MALT (mucosal-associated lymphoid tissue) 2. airways 3. digestive system 4. under the skin |
| Production of IL__ and IL__ can stimulate B cells to produce lots of IgE against the allergen. | Il-4 and IL-3 |
| The 3 basic approaches for testing type I hypersensitivity reactions in the lab are ? | 1. RIST (radioimmunosorbent test) 2. RAST (Radio allergosorbent test) 3. skin testing |
| RIST tests for total __. | IgE |
| RAST tests for IgE to a ? | specific allergen |
| Which test (RIST, RAST, skin test?) employs a capture assay of anti IgE coating and detects the labeled anti-human IgE? | RIST (total IgE) |
| Which test (RIST, RAST, skin test?) is an indirect assay that uses a solid matrix coated with allergen? | RAST (allergen specific IgE) |
| Which test is the simplest to perform and examines the patient's final reaction to the allergen in vivo? | skin test |
| Which test (RIST, RAST, skin test) adds the patients sera and a labeled anti-human immunoglobulin to a solid matrix coated with allergen? | RAST (allergen specific IgE) |
| Name the 2 kinds of skin test. | 1. prick test 2. intradermal test |
| A prick/skin test usually takes how many minutes to show a reaction? | 15-30 mins |
| An intradermal skin test may be used if the prick test is __. | negative |
| Intradermal skin tests are more dangerous than prick tests because they go between different layers of the skin, risking an __ reaction. | anaphylactic |
| Both kinds of skin test employ a negative __ control and a positive __ control. | saline, histamine |
| One way of treating type I hypersensitivity is to give the patient extremely small (but ever increasing) amounts of the allergen over time to gradually inhibit the reaction. This procedure is called ? | hyposensitization |
| Hyposensitization changes the patient's allergic response from an IgE to an __. | IgG |
| Type II hypersensitivity reactions are caused by the reaction of which immunoglobulins? | IgG, IgM |
| The cellular destruction inflicted on a patient by type II hypersensitivity reactions is due to antibody and complement mediated ... (list all 3) | 1. lysis 2. opsonization 3. cellular toxicity |
| The 3 major players of type II hypersensitivity reactions are ? | 1. antibodies 2. complement 3. phagocytes |
| Clinical examples of type II hypersensitivity reactions include what 3 things? | 1. transfusion reactions 2. hemolytic anemias 3. erthroblastosis fetalis (hemolytic disease of newborn) |
| During a transfusion reaction (type II hypersensitivity), the transfusion recipient has circulating __ that target the RBCs of the donor. | antibodies |
| The severity of a transfusion reaction (type II hypersensitivity) can be partially based on the __ of antibodies in the recipient's system. | titer |
| The severity of a transfusion reaction (type II hypersensitivity) can partially depend on the amount of __ __. | blood transfused |
| One thing that affects the severity of a transfusion reaction (type II hypersensitivity) is whether this is the __ transfusion of ABO-incompatible blood or not. | first |
| What 3 kinds of antigens are factors in transfusion reactions? | 1. ABO blood antigens (primary concern) 2. Kelly & Duffy antigens 3. Rh antigens |
| A condition where complement is activated and tries to destroy the body's own RBCs is called ? | hemolytic anemia |
| HDNB stands for ? | hemolytic disease of the newborn |
| HDNB occurs when the mother makes __ antibodies against the RBCs of the fetus. | IgG |
| In HDNB, the mother's IgG antibodies can cross the __ and damage the fetal RBCs. | placenta |
| HDNB only happens when the mother is Rh__ and the baby is Rh__. It never works in the reverse. | negative, positive |
| The most common antigen involved in HDNB is the __ antigen of the Rh blood groups. | D |
| Rh positive means positive for the __ antigen. | D |
| When a pregnant woman makes IgG antibodies against the RBCs of her unborn fetus due to blood-antigen incompatibility, this is called ? | hemolytic disease of the newborn (HDNB) |
| HDBN does not happen during the __ pregnancy. | first (after the first baby, the mother is immunized against the fetal Rh+ cells and her immune system will attack subsequent fetuses that are Rh+) |
| If the mother is Rh postive and the baby is Rh negative, can HDNB occur? | no |
| What are the possible consequences for the fetus in cases of HDNB? | 1. anemia 2. jaundice 3. death |
| What are the 2 types of testing done to check for HDNB? | 1. indirect antiglobulin test (IAT) 2. direct antiglobulin test (DAT) |
| How can you prevent HDNB? | anti-RhD antibodies |
| How can anti-RhD antibodies prevent HDNB? | They can can destroy few fetal RBCs that enter the mother's body before her immune system can become immunized against them. |
| Type III hypersensitivity reactions are caused by immune complexes formed from __ and soluble antigens. | IgG |
| Type III hypersensitivity reactions are immune responses to an antigen in __ rather than on a particular cell or tissue. | solution |
| Type III hypersensitivity diseases can involve antibodies that bind to receptor and __ the response. | modulate |
| 4 examples of type III hypersensitivity reactions include ? | 1. Grave's disease 2. Myasthenia gravis, or Lou Gehrig's disease 3. Goodpasture's syndrome 4. Rheumatic fever |
| Type III hypersensitivity reactions occur when an antibody and antigen bind together, forming a complex that gets stuck in a __ site within the body and then causes an allergic reaction. | filtering |
| The target tissues of type III hypersensitivity reactions are ? | 1. blood vessel walls 2. kidneys (glomerular basement membrane) 3. joints 4. lungs |
| When complement and inflammatory cells try to clear the antibody-antigen complex in a type III hypersensitivity reaction, they end up causing __ to the filtration organs near the complex. | damage |
| What kind of reaction is caused by immune complexes that are generated by IgG that has infiltrated the tissues and combining with an antigen that has been injected intradermally? | Arthrus reaction |
| When the immune system reacts to injected medications that contain animal proteins used to treat immune conditions, this is called ? | serum sickness |
| A 2nd injection using proteins from the same animal species can cause ? (Relating to serum sickness.) | shock and death |
| Normally, serum sickness is self __. | limiting |
| The processes involved in type III hypersensitivity reactions can also occur in certain forms of __ which are not self limiting. | autoimmunity |
| 2 autoimmune diseases that work similarly to serum sickness are ? | 1. Lupus 2. Rheumatoid arthritis |
| Why aren't autoimmune disorders like Lupus and Rheumatoid arthritis self limiting like serum sickness? | These are self-antigens that can't be cleared away. Serum sickness antigens come from outside the body and can be cleared away. |
| Unlike other types of hypersensitivity, type IV hypersensitivity is mediated by ? | 1. CD4 Th1 T cells 2. CD8 cytotoxic T cells |
| Is it true that type IV hypersensitivity can actually be transferred from one animal to another by transferring T cells that have been sensitized to the antigen? | Yes |
| Type IV hypersensitivity can target different areas of the __. | body |
| What example of type IV hypersensitivity is initiated when small substances get in contact with the skin and act as haptens once they have penetrated it? | contact dermatitis |
| The duration of contact dermatitis is ? | From several days to several weeks AFTER removal of the allergen! |
| Because the allergen in contact dermatitis (and by extension, many type IV hypersensitivity reactions) are haptens, they make the affected cells appear __ to the body. Thus, the reaction takes a while to stop. | foreign or immunogenic |
| A positive result from a Mantoux test means that the patient has been exposed to __ __. It does not mean the person has the disease. | mycobacterium tuberculosis |
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IsaacJ
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