immunology exam 2 🦠

Although phagocytic and bactericidal activity are normal, neutrophils are unable to reach the site of infection in which condition?

Lazy leukocyte syndrome

Congenital neutrophil abnormalities

Chadian-Higashi syndrome, chronic granulomatous disease, Lazy leukocytes syndrome, NOT myeloperoxidase deficiency

A hallmark feature of neutrophils of an individual with this condition is giant Ophelia granules. Individuals present with frequent skin infections, photosensitivity and hypopigmentation.

Chadiak-Higashi syndrome

In which condition is the patient unable to generate superoxide to produce an oxidative burst in their neutrophils?

Chronic granulomatous disease

A disorder in which peroxide activity is decrease but afflicted individuals are generally healthy.

Myeloperoxidase deficiency

Individuals with this rare genetic disorder that results in a deficiency of the enzyme that splits glucose from glucosylceramide. The cytoplasm of these cells has “wrinkled”” appearance.

Gaucher disease

This disease has multiple types: a sphingomyelinase deficiency in some types and the inability to properly catabolize cholesterol in another.

Neumann-Pick Disease

Which condition can be life threatening with most patients surviving into their 40’s but will be susceptible to infections from catalase positive bacteria?

Chronic Granulomatous disease

This condition exhibits impaired chemotaxis due to disruption of movement and transport of proteins within the neutrophil.

Chediak-Higashi syndrome

Shingling accumulates in phagocytes and impairs the function of the involved organs of patients inflicted with this disease

Niemann-Pick Disease

The causative agent in the disease syphilis is what organ?

Treponema-pallidum

Central nervous system involvement typically manifested during which stage of syphilis?

Tertiary syphilis

Which body fluid, with a positive VDRL test, is diagnostic for neurotrophic

Cerebrospinal fluid

Name the antibody in the RPR test?

Nonspecific reagin

Darkfield microscopy is used to diagnose the patient in which stage of syphilis?

Primary syphilis

What best describes protein substances on a cell that identifies the cell to immune system as self or non self?

Antigen

Which type of immunity develops as a result of a person having had a disease

Acquired active immunity

In this type of immunity the patient has been given a dose of gamma globulin from an exposure to hepatitis B. Name the type of immunity

Acquired passive immunity

The most primary benefit of having active acquired immunity is.

Prophylaxis

The stage in an antibody response in which the antibody is catabolized is called

Decline

4 stages of adaptive immunity response

Lag phase (no antibody detectable), log phase (antibody titer increases logarithmically), plateau phase (antibody titer stabilizes), decline phase (antibody is Catabolized)

Which class of antibody is the primary detectable type of antibody during a secondary antibody response.

IgG

What best describes a foreign antigen from the same species

Alloantigen

What would not make a good antigen?

Lipids

Which antigen is the single most important antigen that can trigger an acute response?

ABO antigens

Which item does not meet the criteria for a good antigen

Small structure

A good antigen includes:

Foreignness, high molecular weight, stability, very large

Death often occurs in patients with rheumatoid arthritis due to complications involving which organ?

Heart

Which drug is considered to be nonbiological disease modifying anti rheumatic drug?

Methotrexate

Rheumatoid factors are directed against which region of other immunoglobulins

Fc region

Fd region

Fab region

Which symptom is generally not associated with rheumatoid arthritis

Swollen lymph nodes

Arthritis due to old age

Osteoarthritis

Cellular antigens of clinical importance

Molecular markers on the cell that can trigger an immune response

Physical nature of antigens

Foreigners (being able to recognize non-self from self), degradability (antigens are processed by the body’s antigen presenting cells), molecular weight ( need to be big and strong so size and shape isn’t affected), complexity (chemical composition)

Chemical nature of antigens

Proteins, lipids, haptens, polysaccharides help antigens in immune response

3 types of antigens

Exogenous, endogenous, autoantigens

Another name for antibodies is which one of the following names?

Immunoglobulins

What does the fab region of an antibody molecule contain?

The top of the heavy chain and the entire light chain

Which region of the immunoglobulin molecule directs biological activity of the molecule

Fc region

Which is an example of light chain name

Lambda and kappa

Which antibody is considered pentamer

IgM

Which antibody crosses the placenta

igG

How many subclasses of igG exist

4

Which antibody has a secretory component

Iga

Which antibody is thought to play a role in B-cell development

IgD

The part of the IgG molecule that allows the molecule to bend and twist around the host tissue and the antigen

Hinge region

Which of the below diseases is also known as 3 day measles or German

Rubella

TORCH testing includes testing for?

Toxoplasma gondii, herpes, CMV

Measles is not?

DNA virus it is RNA

Up to 80% adults have been infected

CMV

Which of these choices is caused by RNA virus

Rubella

Etiology

Caused by the spirichete (bacteria): treponema pallidum, hard to cultivate, dark field microscopy, diagnosed immune chemically

Syphilis epidemiology

T pallidum enters intact mucous membrane, incubates 3 weeks, moves to every organ

Syphilis epidemiology stages

Primary (painless, contagious, dark field microscopy), secondary (80% rashes lesions develop 2-8 weeks after chancre appears, meninigistis progressing to neurosyphilis, serum antibodies RPR or VDRL; TP-PA), latent (asymptomatic but may relapse, congenital, only with serology), Teritary (granulomas, cardiovascular, CNS, brain, CFS VDRL)

Antitreponemal antibodies

Antibodies specific for T. Pallidum

Nontreponemal antibody

Always produced with syphilis, antilipoidal antibodies directed against self or other cells

Rapid plasma reagin (RPR) and VDLR

RPR test most widely used nontreponemal serologic procedure, VDLR flucculation test for reagin

Hapten

A low molecular weight molecule that can bind to a larger molecule and behave as antigen

Types of antigens

Auto antigen (self), alloantigen (in another member), blood group antigen (present on blood cells and tissues), herteroantigen (from different species), ABO group (important blood group antigen)

How to test for arthritis?

Agglutination test, C-reactive protein, anti nuclear antibodies, anti CCP, erythrocyte sedimentation rate

Immunoglobulin M (igM)

10% of serum, pentamer, largest molecular sized antibody class, doesn’t cross placenta, first class produced

Immunoglobulin G (igG)

Most abundant, 70-75% in serum, 2nd class produced, crosses placenta, long half life, weak agglutination, can diffuse into extracellular spaces, enhances phagocytosis

Immunoglobulin A (iga)

15-20% in serum, secretory component, monomer, dimer

Immunoglobulin D (igD)

Less than 1% in serum, cell surface of B cells, doesn’t cross placenta or fix complement

Immunoglobulin E (igE)

1% in serum, monomer, no crossing placenta or fixed complement

Torch

Infections infect fetus or newborn

Toxoplasmosis

Toxoplasma gondii, asymptomatic, blindness retardation, test using ELISA for IgM or igG, Sabin dye test, avidity, PCR, indirect flourescent

Rubella

German measles, RNA virus, respiratory, bone defects heptomegally, igM or igG test and nucleic acid testing (NAT)

Rubeola

Measles, live, respiratory droplets, since live don’t get vaccine to pregnant

Cytomegalovirus

Transmission (oral, respiratory, venereal), transfusion of fresh blood, crosses placenta, congenital infection

Complement C3 receptor deficiency

Rare autosomal recessive disorder trait, adhesion deficiency, decreased marinating pools