Immunology and Serology

Type of Immunity Associated with immunization

Active

Type of cell that produces antibody

B cells

Immunity Associated with Viral Infections

Cellular

Immunity associated with Bacterial Infections

Humoral

Phagocytosis and NK cells are part of what immunity?

Natural

T cells and B cells are part of ____ immunity

Adaptive

What type of immunity is associated with rubella immunization?

Active

What type of immunity is associated with neonatal syphilitic IgG antibody titers?

Passive

Individual produces antibody

Follows Immunization or Infection

Memory

Active

Antibody Transferred to Individual (gamma gobulin injections, placental transfer)

No memory

Passive

Cellular/Humoral?

T cells/Lymphokines

Cellular

Cellular/Humoral?

Defense against Bacterial infections by phagocytosis

Humoral

Cellular/Humoral?

Hypersensitivity Type IV (delayed)

Cellular

Cellular/Humoral?

Hypersensitivity Type I (immediate)

Humoral

Cellular/Humoral?

Hypersensitivity Type II (ADCC)

Humoral

Cellular/Humoral?

Hypersensitivity III (Immune Complex)

Humoral

%of Total Circulating Lymphoid Cells for: T Cells

80%

%of Total Circulating Lymphoid Cells for: B Cells

5-15%

%of Total Circulating Lymphoid Cells for: NK Cells

5-15%

T/B/NK Cells?

Surface Markers of CD2, CD3, CD4, CD25, CD8

T Cells

T/B/NK Cells?

Surface Markers: CD19, CD20, CD21

B Cells

T/B/NK Cells?

Surface Markers: CD16, CD56

NK Cells

Function of B Cells

Evolve into plasma cells which secrete antibody

Become memory cells

Function of NK cells

Kill virus infected cells and tumor cells

CD4 Function

Release cytokines

Become memory cell

CD8 Function

Become cytotoxic

CD4/CD8 function

Interact with B cells

CD4/CD25 function

suppress immune system

T Helper surface marker

CD4

T Cytotoxic surface marker

CD8

Normal CD4:CD8 ratio

2:1

AIDS CD4:CD8 ratio

1:2

Normal T cell:B cell ratio

8:1

T and B cells can be describe as what kind of WBC?

small lymphocytes

Immune Response Curve Graph

first arrow is showing the ____ dose

Sensitizing

Immune Response Curve Graph

second arrow is showing the ____ dose

Booster

Immunoglobulin Antibody Classes: G.M.A.D.E

Greatest plasma concentration (~75%)

Goes across placenta

IgG

Immunoglobulin Antibody Classes: G.M.A.D.E

Largest immunoglobulin molecule

Activates complement

IgM

Immunoglobulin Antibody Classes: G.M.A.D.E

Body Secretions

IgA

Immunoglobulin Antibody Classes: G.M.A.D.E

Don’t know function

Present with B cells

IgD

Immunoglobulin Antibody Classes: G.M.A.D.E

Allergy reactions

Type I hypersensitivity

IgE

Precipitation Curve: Pros Have Good Bodies

Prozone=____ excess

antibody

Precipitation Curve

Postzone is ____ excess

antigen

Precipitation Curve

Equivalence = Max _____

precipitation

Visible precipitation forms as a

lattice

Double and Single diffusion

Immunoelectrophoresis

Immunofixation

These are all examples of:

Precipitation Testing

Skin tests, RIST, RAST will all test for

Allergies

Hypersensitivity Reaction Types:

Bee sting

Hay fever

Asthma

Type I

Hypersensitivity Reaction Types:

Transfusion reaction

Autoimmune Hemolytic Anemia (AIHA)

Hashimoto Thyroiditis

Goodpasture disease

Type II

Hypersensitivity Reaction Types:

Rheumatoid Arthritis (RA)

Systemic Lupus Erythematosus (SLE)

Serum Sickness

Type III

Hypersensitivity Reaction Types:

Contact Dermatitis (poison Ivy, Chemicals)

TB

Leprosy

Graft vs Host Disease

Type IV

Mechanism for Type I Hypersensitivity Reaction:

It is _(immunoglobin)__ mediated where the antigen binds to the ____ cells which triggers ____ to release

IgE

Mast

Histamine

Cascade (pathways) require:

magnesium and calcium

Classical pathway is activated by the:

Immune complexes (IgG/IgM)

Complement Binding order for Classical Pathways (C1, C2, etc)

C1, C4, C2, C4

Classical Pathway: “a” fragments go into _____ while “b” fragments attach to _____

plasma

cell

Alternative pathways are activated by:

lipopolysaccharides

polysaccharides

Alternative Pathway involves mainly this complement:

C3

Alternative pathway involves Factors ___ and ___, and Control Factors ___ and ____

B and D

H and I

Membrane Attack Complex (MAC) last Complement (goes in order):

C5b6789

In Hypersensitivity Type I, Eosinophils are in the late/early stage of the reaction and can lead to ___ ____

late

tissue damage

ELISA type for total IgE

Sandwich (EIA)

IgE specific antigens

Allergens

Most sensitive test in all stages of Syphilis?

FTA-ABS and ELISA

Clinical Sensitivity

Ability of test to give positive results if patient has the disease

Clinical Specificity

Ability of test to give negative results if patient does not have disease

How to determine diagnosis of Viral and Bacterial disease using titers

Must see 4-fold or 2 tube rise in titer to be clinically significant

These tests are MORE/LESS sensitive:

Immunoassays

Nephelometry

MORE

These tests are MORE/LESS sensitive:

Agglutination

Precipitation

Complement Fixation

Immunodiffusions

Electrophoresis

LESS

Lattice tests are MORE/LESS sensitive while Nonlattice tests are MORE/LESS sensitive

LESS

MORE

Best marker for inflammation

CRP

Analytical Specificity

Ability of test to detect substances without interference from cross-reacting substances

False negatives yield lower _____; False positives yield lower _____

sensitivity

specificity

VDRL

Heat inactivation required for this Non-Treponemal test

RPR

This Non-Treponemal test will have charcoal clumps form as its reaction

False positives for VDRL and RPR

malaria , SLE, RE, hepatitis, pneumonia, aging, and infectious mononucleosis

Antibody used in Non-Treponemal tests

Reagin

EBV Specific Serology Methods

Indirect Immunofluorescence, ELISA, or CLIA

Recent or Current EBV infection methods

IgM Anti-VCA, Anti-EA, IgG Anti-VCA without Anti-EBNA

Past EBV Infection Methods

Anti-EBNA, IgG Anti-VCA without IgM Anti-VCA

Most specific test for Strep Group A?

anti DNase B

HIV screening method

ELISA for HIV-1 antibody

HIV confirming test (CDC recommended)

Nucleic Acid testing

HIV confirming methods

Western blot

nucleic acid

Western Blot method: HIV positive if what bands are present?

p24, gp41, gp120, gp160

Disease Associated with Oligoclonal IgG Bands in Spinal Fluid

Multiple Sclerosis

The best method for screening cerebrospinal fluid for syphilis

VDRL

Processing: What should you NOT do to specimens testing for Cold Agglutinin Assay?

refrigerate them

This disease results in hyperthyroidism

Graves Disease

This disease results in hyporthyroidism

Hashimoto’s Thyroiditis

Chronic Granulomatous Disease dysfunction

Ineffective Phagocytosis

Chediak-Higashi Syndrome dysfunction

Impaired Neutrophil Function

DiGeorge’s Syndrome dysfunction

T cell Deficiency

HIV dysfunction

Decreased: T-Helpers, Th/Ts Ratio, T Cell Proliferation

Wiskott-Aldrich Syndrome dysfunction

Partial Combined Immunodeficiency

Severe Combined Immunodeficiency Disease (SCID)

Complete or Marked Deficiency of T and B Lymphocytes

This is positive in all celiac patients

HLA-DG2 and HLA-DQ8

Best antibodies to test for in celiac patients

tTG-IgA and tTG-IgG

Antibodies in Hashimoto’s Thyroiditis and TSH are all INCREASED/DECREASED

increased

Antibodies in Graves disease are INCREASED/DECREASED while TSH is INCREASED/DECREASED

increased

decreased