BOC ASCP Recalls Exam Questions with Complete Solutions Graded A

  In the anti-double-stranded DNA procedure, the antigen most commonly utilized is: - Answer: The Crithidia luciliae antigen is used. C. luciliae has giant mitochondrion that contain native DNA that is free from contaminating histone antigens. It is used in SLE diagnosis. C3b function - Answer: which lands on the target surface and becomes part of C5 convertase, is also a powerful opsonin Rheumatoid factor - Answer: anti-Ig*M* or G that binds to the Fc portion of an abnormal IgG. + in 75% of RA patients but also possible in some chronic infections,SLE or syphillis. Rheumatoid arthritis general - Answer: systemic inflammatory disease. produce IgG or M** antibodies against IgG in the synovium. forming an immune complex that activated complement. The inflammatory response proceeds and destroys the synovium. Immune complexes attract neutrophils and macrophages to the joint that degranulate and cause tissue destruction.. Symptoms: joint pain, morning stiffness, rheumatoid nodules, vasculitis Rheumatoid arthritis labs - Answer: increased: eSedRate, CRP, positive: RF, cryoglobulins, ANA(homogenous) synovial fluid: cloudy, WBC 5-20,000/uL, increased protein, poor mucin clot development, decreased complement allotype antibodies - Answer: allo=different the types of antibodies found within one species multiple alleles exist for the constant regions of the antibody heavy and light chains So if we take antibodies from one member of the species and inject it into another member of the same species it will result in production of antibodies against allotypic determinants. this is observed during blood transfusions or pregnancys idiotype antibody - Answer: Idio-own in the variable region of the heavy and light chains. Idiotypes are the unique antigenic determinants present on variable heavy chain and variable light region of individual antibody molecules. the types of antibodies found within one individual important in vaccines. and treatment of b cell tumors In identical twins: iso and allotypes are the same but idiotype is different isotype antibody - Answer: iso=same It is called isotype (iso = same) because all members of a given species expresses all the isotypes in the serum.For example, all immunologically normal individuals will have all five types of antibodies present in their serum i.e. IgM, IgA, IgG, IgE and IgD. the constant regions of light and heavy chains. Observed: In all the individuals of a species (immunologically normal individuals). important in measuring Ig levels, checking for immunodeficiency and b cell tumors Hairy cell leukemia - Answer: CD: 11c, 19 ,20, 22, 25,103, FMC7 Tartrate-resistant acid phosphatase stain (TRAP): resistant to inhibition with tartrate and will stain positive with all other cells staining negative IgG subclasses - Answer: IgG1: Most abundant and versatile. intermediate flexibility and complement activation. Prone to proteolysis. best crosser of placenta IgG2: 2nd most abundant. Less flexible but little more sturdy and ok compliment. For highly repetitive CHO antigens = not need flexi.. responds to bacterial capsular polysaccharide antigens. assoc with autoimmune disease IgG3: Best compliment activator of Igs. very flexible. Very prone proteolysis. potent pro-inflammatory ab IgG4: least abundant. stout and sturdy to help parasite infection. bc parasite huge. allergens induce. assoc with autoimmune disease IgG often have lots of somatic mutations in V HC bc affinity matured FTA-ABS test - Answer: fluorescent treponemal antibody-absorption test. A serological test for syphilis (performed on blood serum) looking for antibodies to T. pallidum. A whole bacteria (cultured from rabbit testicles) is dried to a slide and pt serum+absorbent is added to slide. if ab present to bacteria, they bind. A fluorophore labeled antitreponeme antibody (FITC) is added and TRITC is added. the FITC stain will locate the spirochete and TRITC staining will is the pt ab. False positives with SLE patients as a beaded pattern of fluorescence is seen. ANA pattern: homogenous - Answer: anti-dna, histone, DNP Nucleolar - Answer: anti-scl-70, anti-RNP, anti-RNA, speckled - Answer: anti-SM, anti-RNP anti-Ro, antiLA antiJo1, anti-Mi2 anti-SCL70 centromere - Answer: homogenous - Answer: SLE MCTD Drug induced lupus Juvenile Idiopathic Arthritis speckled - Answer: SLE Sjogren's syndrome polymyositis/dermatomyositis systemic sclerosis or scleroderma nucleolar - Answer: diffuse sclerosis/scleroderma polymyositis centromere - Answer: CREST peripheral - Answer: Diseases: SLE and scleroderma... AB detected: ds-DNA complement control proteins - Answer: C1 inhibitor: combines with C1r and s to block C1 C3 inactivator: cleaves C3b into C3c and d anaphylatoxin inactivator: removes amino acid from C4a, C3a, and C5a rendering them useless and anaphylatoxin MAC inhibitors: MAC is not formed because S protein binds to complex( C5b-7) Complement receptor type 1: binds C3b and C4b to inhibit the amplification loop VDRL antigen - Answer: Cardiolipin-lecithin-cholesterol (contains cholesterol to increase the sensitivity of the antigen HBeAg indicates - Answer: viral replication and infectivity and is present in pt serum during periods of active HBV replication so is a marker of high infectivity p-ANCA - Answer: shows a IF staining pattern of perinuclear or nuclear on leukocyte fixed slides C-ANCA - Answer: shows a granular cytoplasmic staining pattern of leukocyte fixed slides Window period of Hep B - Answer: - HBsAG (-) - anti-HBs (-) - anti-HBc: IgM (+) HBsAg has disappeared and anti-HBsAg has yet to appear. indicated the late stage of acute hepatitis b Goodpasture syndrome - Answer: type II hypersensitivity Autoantibodies against the type IV collagen in the basement membrane of the kidneys and lungs. Damage to alveolar and renal glomerular basement membranes by cytotoxic antibody. Which of the following is decreased in serum during the active stages of systemic lupus erythematosus? - Answer: complement (C3). C3 becomes depleted due to the autoantibody called C3-nephritic factor (C3NeF). autoimmune theory - Answer: forbidden clone: error in self-recognition during fetal life and lymphs aren't destroyed clonal anergy: clones during fetal life are not stimulated by lose doses of antigens so they are able to produce ab against higher doses of antigens sequestered-antigen: some antigens are hidden from immune system during fetal development. immunologic deficiency: suppressor t cells have decreased activity so b cell antibody production not controlled molecular mimicry: ab or reactive t cells to an infectious agent cross react with self polyclonal b cell activation: bacteria and viruses that stimulate b cells can allow b cells to have self reactivity HLA-BB - Answer: graves disease and type 1 diabetes HLA-DR2 - Answer: SLE, hashimotos, myasthenia gravis HLA-DR3 - Answer: Diabetes mellitus type 1, SLE, Graves disease, Sjogren syndrome, myasthenia gravis HLA-DR4 - Answer: Diabetes mellitus type 1, rheumatoid arthritis, pemphigus vulgaris ankylosing spondylitis - Answer: a form of rheumatoid arthritis that primarily causes inflammation of the joints between the vertebrae. More than 95% of patients with ankylosing spondylitis are positive for the HLA-B27 antigen; therefore, a positive result for this test would support the diagnosis. Hereditary deficiency of early complement components (C1, C4 and C2) is associated with - Answer: C1, C4, C2 deficiencies are associated with a lupus erythematosus-like syndrome Hereditary deficiency of late complement components (C5, C6, C7 or C8) can be associated with which of the following conditions? - Answer: C5, C6, C7, C8 deficiencies are associated with a worse Neisseria infection if the patient is exposed due to less pathogen clearance. anti-Smooth Muscle Antibody (ASMA) - Answer: associated with autoimmune chronic active hepatitis (CAH). affecting the liver and other tissues Chronic active hepatitis (CAH) has at least 2 subsets, the classic or type I, which is associated with a positive ANA test and positive smooth muscle antibodies. The condition is associated with an attack on the hepatocytes. False-positive rheumatoid factor in agglutination and nephelometric methods can be due to elevated levels of - Answer: C1q. like RF, can bind and cross link IgG giving a false positive Rheumatoid factor in a patient's serum may cause a false: - Answer: can cause a false positive for the detection of IgM class antibodies IgM RF is the species most commonly measured in clinical assays. RAST - Answer: blood test that measures the amount of IgE produced each time the blood is mixed with a specific allergen. a method for testing for allergic reactions ASO neutralization test - Answer: pt antibodies to streptolysin O will prevent hemolysis of RBCs by reagent streptolysin O because it will be complexed with pt ab. The complement added will not initiate hemolysis of reagent RBC if pt has ab. The titer will be the last tube with no hemolysis. as expressed in Todd units (1:8 = 8 Todd units) What percentage of T cells are CD4? - Answer: 25-65% (avg40%) of lymphocytes is helper cells. If The patient's percent of CD4+ cells is (8%) it is well below the normal range of 50 - 60%, and the patient's absolute number of CD4+ cells (5,000 × 0.15 × 0.08 = 60) is also far below the normal range of 500 - 1,300 cells/µL peripheral blood. These findings are consistent with AIDS, which is caused by HIV. Methods of target amplification in molecular testing include all but: - Answer: primer amplification. Primer amplification is not intended as a consequence of PCR, but it may occur as a procedural confounder, ie, primer dimer.