IMMUNOLOGY AND SEROLOGY INTENSIVE RECAP A.Y.

2018-2019

NAME: ,RMT

REVIEW QUESTIONS

1. What disease was contracted and carried from the New World to the Old World by Columbus’ crew?
A. Tuberculosis B. Paragonimiasis C. Syphilis D. HIV

New world= America Europe to America_________________________

Old world= Europe America to Europe_________________________

HISTORY
SCIENTIST CONTRIBUTION 430 BC- Thucydides recorded
Edward Jenner Father of Immunology, Vaccination recovery of persons infected by the
Louise Pasteur Pasteurization plague and recognized their immune
Cellular Theory of Immunity, Phagocytosis
status
Bordet and Gengou Complement Fixation
Grabar and Williams Immunoelectrophoresis Analysis in Gels 1500- Chinese immunization through
Paul Ehrlich Immunity, Side Chain Theory
inhalation of crusts of smallpox
Friedrich Brent/Felix Haurowitz Template Theory of Antibody Production
lesions
Niels K. Jerne/ Frank Burnet Clonal Selection Theory, Immunoregulation
Peter Gorer/Jean Histocompatibility Complex
1718- _______________(injection of
Dausset/George Snell/
Baruj Benaceraf materials from smallpox blisters) in
Cesar Milstein/ Georges Monoclonal Antibodies via Hybridoma eastern medicine and later
Kohler introduced to western medicine by
Emil von Behring Serum antitoxins Lady Mary Wortley Montagu
Robert Koch Cellular Immunity to TB
Chares Richet Anaphylaxis 1796- Edward Jenner demonstration
Karl Landsteiner Human Blood Group Antigens of vaccination (from Latin: vacca-
The Specificity of Serologic Reactions cow) by inoculating an 8-year-old
Macfarlane Burnet/Peter Immunologic Tolerance boy with fluid from a cowpox pustule
Medawar
Gerald Edelman/ Rodney Structure of Antibodies 1867- Asceptic practice in surgery
Porter using carbolic acid (Jospeh Lister)
Rosalyn Yallow Radioimmunoassay
Antibody Diversity 1880-1881- Louise Pasteur
Edward Donnall Transplantation discovered vaccines against:
Thomas/Joseph Murray
Cholera and Anthrax
Peter Doherty/ Cytotoxic T cell regulation of virally-infected
Rabies (1985)
Rolf Zinkernagel cells
François Barré-Sinoussi/ HIV
1903- Opsonization
Luc Montagnier
Robert Kaus Precipitins 1945- Coomb’s test
Daniel Bovet Antihistamines
________________-Cook who killed
2. Which disease might be indicated by antibodies to smooth muscles? several people by transmitting
A. Autoimmune hepatitis C. Primary Billiary Cirrhosis typhoid fever
B. Hashimoto’s Thyroiditis D. Myasthenia Gravis
Disease Antibody
Goodpasture’s syndrome
Wegener’s granulomatosis ANCA (Anti-neutrophilic cytoplasmic antibody)
Pernicious anemia Anti-IF (intrinsic factor)
Anti-parietal cell
Multiple sclerosis Anti-myelin sheath
Myasthenia gravis Anti-acetylcholine receptors
Type I DM Anti-islet cells
Grave’s disease
Hashimoto’s thyroiditis LATS (Long-Acting Thyroid Stimulating Cells)
Anti-TPO (Thyroperoxidase)
Anti-microsomal antibodies
Celiac disease IgA anti-tissue transglutaminase
Chronic active hepatitis/ Autoimmune hepatitis
Primary Biliary cirrhosis
Rheumatoid Arthritis Anti-DNP, RF
SLE Anti-dsDNA, Anti-Smith, LE Factor
 FLOURESCENT (ANTI-NUCLEAR ANTIBODY)
Flourescent Pattern Antibody Disease Association
Homogenous/Diffuse/Solid Anti-DNP Rheumatoid disorder
Peripheral/Ring/Rim/Membranous Anti-dsDNA Most specific for SLE
Active stage of SLE
Speckled/Mottled/Pepperdot Anti-ENA (Requires further testing) Anti-SM= SLE
-anti-SM Anti-RNP= MCTD, SLE, RA
-anti-RNP
Nucleolar Anti-nucloelar RNA Scleroderma
Centromeric Anti-centromere CREST syndrome

3. Basophils and Mast cells are under what type of hypersensitivity?

A. Type I B. Type II C. Type III D. Type IV
4. Hives and itching are under what type of hypersensitivity?
A. Type I B. Type II C. Type III D. Type IV
TYPE I TYPE II TYPE III TYPE IV
NAME Anaphylactic Cytotoxic Immune-complex Cell-mediated
MEDIATOR
MECHANISM Release of mediators, Cytolysis due to Abs Deposition of Ag-Ab Release of cytokines
mast cells and basophils and C’ complexes
EXAMPLES Anaphylaxis Transfusion Serum sickness Contact dermatitis
Hay fever reactions Arthus reaction Tuberculin test
Food allergies AIHA SLE Pneumonitis
Asthma HDN

5. TPI test shows 10% treponemes are immobilized; Interpret the result.
A. Positive B. Negative C. Doubtful D. Indeterminate
6. When grading for slide agglutination for Salmonella, macroscopic agglutination is graded as 25%. Interpret.
A. Non-reactive B. Positive C. Reactive D. 1+

TPI (Treponema pallidum immobilization test) >50% Positive

20-50% Doubtful
<20% Negative
RF latex test >80 Positive
20-40 Weakly positive
<20 Negative
Widal Agglutination test No agglutination ________________
25% ________________
50% ________________
75% ________________
100% ________________

7. What antigen of P. falciparum is being detected by MalaQuick Standby Malaria Test?

A. HRP-I B. pLDH C. HRP-II D. SREHP
TEST ANTIGEN DETECTED SEEN IN
OptiMal All Plasmodium spp.

MalaQuick P. falciparum only

*sensitivity of OptiMal= 100-200 parasites/ul of blood

8. Large Granular Lymphocytes (LGL) are part of:
A. Natural Immunity B. Classical pathway C. Alternative Pathway D. Acquired Immunity

LGL aka __________________________; part of ______________________

T and B cells ; part of______________________

9. Hybridomas are formed from:

A. Antibodies B. T lymphocytes C. B lymphocytes D. Phagocytes
10. It is a non-specific indicator of inflammation believed to be an antibody to the C-polysaccharide of pneumococci:
A. Serum amyloid A B. α1-Antitrypsin C. CRP D. Ceruloplasmin

APR RESPONSE TIME (hr) INCREASE FUNCTION

Opsonization,
C-reactive Protein 6-10 1000x
C’ activation
Serum Amyloid 1 24 1000x Removal of cholesterol
α1-Antitrypsin 24 2-5x Protease inhibitor
 Fibrinogen 24 2-5x Clot formation
Haptoglobin 24 2-10x Binds free hemoglobin
Binds copper, oxidizes
Ceruloplasmin 48-72 2x
iron
C3 48-72 2x Opsonization, lysis

 APRs are plasma proteins produced primarily by hepatocytes that increases rapidly by at least ___% due to
infection, trauma, or injury resulting to inflammation
 _______________________ decrease during inflammation, Ex:____________

11. Marker of NK cells:

A. CD19 B. CD34 C. CD45 D. CD56

MARKER EXPRESSION
CD2 Precursor and mature T cells; NK cells (sheep RBC receptor)
CD3 Precursor and mature T cells
CD4 Precursor T cells, T helper cells, monocytes
CD8 Precursor T cells, T suppressor cells, T cytotoxic cells, subset of NK cells
CD10 Precursor B cells, germinal center B cells, granulocytes
CD14 Mature monocytes
CD16 Granulocytic and monocytic lineage, NK cells
CD19 Precursor and mature B cells
CD20 Precursor and mature B cells
CD21 Immature B cells
CD34 Hematopoietic Stem cells
CD45 Hematopoietic Stem cells
CD56 NK cells, subset of T cells

12. HLA-B27 is most commonly associated with:

A. SLE C. Rheumatoid Arthritis
B. Ankylosing spondylitis D. Graves Disease

HLA DISEASES
Multiple Sclerosis
Grave’s disease, Myasthenia Gravis, Addison’s disease, Type I DM, Sjögren syndrome, SLE
Ankylosing spondylitis, Reiter’s syndrome, Juvenile RA
Goodpasture syndrome, Narcolepsy
Gluten-sensitive enteropathy, SLE, Type I DM
Pemphigus, RA. Type I DM

*_________________________-Autoimmune disease with the highest criteria for HLA-disease relationship

13. What is the last step in the process of phagocytosis

A. Initiation B. Engulfment C. Digestion D. Chemotaxis
14. C3b is a/an:
A. Anaphylotoxin B. Opsonin C. Chemotaxin D. Cytokine

C1_______________________________ C3a,C4a,C5a______________________
C3_______________________________ C5a______________________________
C3b______________________________

CLASSICAL ALTERNATIVE LECTIN

Activating Substance LPS (bacterial Capsule), Mannose group on
Immune Complex
IgA microbial cell
Recognition Unit C1q,C1r,C1s C3, Factor B, Factor D MBP, MASP-1
C3 convertase C4b2a C3bBb C4b2a
C5 convertase C4b2a3b C3bBb3b C4b2a3b
MAC C5b6789
End Result Cell Lysis

Why is it called classical pathway?_________________________________________

AKA Properdin/Bypass pathway:__________________________________________
Complement is inactivated at what temperature?_____________________________
15. What is the most common complement component deficiency?
A. C1 B. C2 C. C3 D. C4

PROTEIN DEFICIENCY DISEASE CORRELATION

C1 SLE
C2 SLE, DLE, juvenile RA, glomerulonephritis (Autoimmune diseases)
C3 Recurrent pyogenic infections, glomerulonephritis
C4 SLE
C5, C6, C7, C8 Neisseria Syndrome, SLE (C5), Reynaud’s disease(C7)
C9 None
C1 INH Hereditary angioedema, autoimmune diseases
DAF and HRF PNH
Factor H or I Recurrent pyogenic infections
CR1 SLE
CR3 Recurrent pyogenic infections, glomerulonephritis

16. Which of the following is the most common immunodeficiency?

A. Severe combined immunodeficiency C. Selective IgA deficiency
B. X-linked agammaglobulinemia D. Common variable immunodefiency

Wiskott-Aldrich syndrome (WAS) Thrompocytopenia, eczema, immunodeficiency

Ataxia-telangiectasia
Waldenstrom’s Macroglobulinemia
Leukocyte adhesion deficiency
syndrome
DiGeorge syndrome
Uncoordinated muscle movements (Ataxia)
Dilation of blood vessels (Telangiectasia)
Decreased IgG2, IgA, IgE
Recurrent bacterial infections and sinusitis
Selective IgG deficiency may occur
Markedly increased IgM but decreased decreased levels of other Abs
Thymic aplasia, absence of T cells

17. These are expressed in the developing fetus and in rapidly dividing tissues, such as that associated with tumors,
but that are absent in normal adult tissues:
A. Oncogens B. Oncofetal antigens C. Sarcoma D. Tumor specific antigen
18. Oher name for HCV RNA:
A. Viral clade B. Surface antigen C. Viral load D. Core antigen
19. Polymerase Chain Reaction (PCR) is a/an ________________ assay.
A. Chemical B. Molecular C. Enzymatic D. Biologic
20. Restriction Fragment Length Polymorphism (RFLP) is a/an ________________ assay.
A. Chemical B. Molecular C. Enzymatic D. Biologic

Coagglutination Direct Agglutination Hemagglutination

Passive Agglutination Reverse Passive Agglutination Flocculation

21. Uses bacteria as inert particles to which antibody attach___________________

22. Antigen is found naturally on surface of particle___________________________
23. Antigen is found naturraly on RBC’s____________________
24. Antigen is attached to a carrier; agglutination occurs when antibody is present_________________
25. Antibody is attached to a carrier; agglutination occurs when antigen is present_______________
26. Special type of precipitation involving fine particles__________________________
27. Antibody is incorporated into gel medium; Ag is placed on well; diffuses and reacts with the Ab; diameter of
precipitation is measured____________________
28. Measurement is taken before the point of equivalence (18 hrs)________________________
29. Antibody is incorporated into a gel medium; Ag is applied on medium, diffuses and reacts with the Ab, producing a
precipitin band________________________________
30. Not included as a hepatitis B serologic marker:
A. HBcAg B. HBeAg C. Anti-HBeAg D. Anti-HBcAg
31. Standard screening test for HIV/AIDS_________________________
32. Standard confirtmatory test for HIV/AIDS______________________
33. Proteins separated in the Western Blot test are blotted on_________________
34. Western Blot bands that confirm (+) HIV infection (at least 2/3 bands)_______________
35. Which of the following activates both T and B cells?
A. Pokeweed mitogen B. Lipopolysaccharide C. Concanavaline A D. Phytohemagglutinin
 MITOGENS
T cell mitogen Concanavalin A, Phytohemagglutinin, Pokeweed mitogen
B cell mitogen Lipopolysaccharide, Pokeweed mitogen

36. Immunoglobulin found in secretions:

A. IgG B. IgA C. IgM D. IgE
37. Pentameric Immunoglobulin:
A. IgG B. IgA C. IgM D. IgE
38. Reagenic Immunoglobulin:
A. IgG B. IgA C. IgM D. IgE
39. The flexibility of the hinge region is due to what amino acid?_____________________________
40. Pepsin cleaves IgG into _______fragments; Papain cleaves IgG into ____________ fragments.

IgG IgA IgM IgD IgE

160,000-400,000
Molecular Weight 150,000 da 900,000 da 180,000 da 190,000 da
da
Sedimentation
7s 7s 19s 7s 8s
Coefficient
Half Life 23 days 5 days 6 days 1-3 days 2-3 days
Domains 4 4 5 4 5
Yes (except Alternative Yes (most
C’ fixation No No
IgG4) pathway only efficient)
Location of hinge region________________
Binds complement____________________
Responsible for Fc receptor binding site________________________

Sources:
Review and Recall Questions by Cua and Yamzon
Lecture notes by Jude Anthony Trinidad, RMT, MSMT
Errol Coderes, RMT