PCD

Question 1

mature B cell capable of synthesizing antibodies

Answer 1

PLASMA CELL

Question 2

are proteins with gamma electrophoretic mobilities that are synthesized in response to an antigen

Answer 2

ANTIBODIES (IMMUNOGLOBULINS or g GLOBULINS) –

Question 3

Activators of classical complement pathway

Answer 3

IgG

Question 4

Hemaglutinins

Hemolysins

Answer 4

IgG

Question 5

Most common (80%)

Answer 5

IgG

Question 6

Precipitating antibody

Virus-neutralizing antibody

Answer 6

IgG

Question 7

Synthesized by plasma cells found in the respiratory and GI tracts and most excretory organs

Answer 7

IgA

Question 8

First line of defense for mucosal surfaces

Answer 8

IgA

Question 9

Second most abundant (10-15%)

Answer 9

IgA

Question 10

First antibody to appear in response to an antigenic challenge

Answer 10

IgM

Question 11

Circular pentameric arrangement

Answer 11

IgM

Question 12

Largest antibody

Answer 12

IgM

Question 13

5-10% of circulating antibodies

Localized in blood

Answer 13

IgM

Question 14

“Ragweed” antibody

Answer 14

IgD

Question 15

Trace concentrations

Answer 15

IgD

Question 16

MW = 140,000 daltons

Answer 16

IgD

Question 17

Functions in lymphocytic activation and suppression

Answer 17

IgD

Question 18

Mediates allergic reactions and parasitic infections

Answer 18

IgE

Question 19

Attaches to mast cells and basophils

Answer 19

IgE

Question 20

“Reagenic antibody”

Answer 20

IgE

Question 21

detects imbalance of Ig of free H or L chains

Answer 21

IMMUNOELECTROPHORESIS and IMMUNOFIXATION ELECTROPHORESIS

Question 22

Most common disease of plasma cells

Answer 22

MULTIPLE MYELOMA

Question 23

MULTIPLE MYELOMA

Predisposing factors

Answer 23

Genetics

Chronic antigenic stimulation

Question 24

Begins in the bone marrow with lytic bone diseases and osteoporosis

Answer 24

MULTIPLE MYELOMA

Question 25

Igs produced are mostly of the _ class (50%) or _ (20%) or L-chains only __ (15%) or _ (25%)

Answer 25

IgG IgA (Bence-Jones Protein) Amyloid

Question 26

CLINICAL PRESENTATION

Answer 26

HyperCalcemia Renal insufficiency Anemia Bone lesions

Question 27

LABORATORY FINDINGS

Answer 27

N/N anemia ESR elevated due to increased globulins Rouleaux formation Few abnormal plasma cells BM = 10-15% plasmacytes Urinary protein (strip and SSA) – not sensitive due to their specificity to albumin (+) casts – hyaline or tubular epithelial casts Electrophoresis – monoclonal peak Hyperuricemia Hypercalcemia Radiologic exams

Question 28

MYELOMA CELL CHARACTERISTICS

Answer 28

Large with immature appearing chromatin OR small with clumped chromatin Pale or dark (depending on cytoplasmic RNA) Sometime bizarre and multinucleated or lobulated nuclei Inclusions

Question 29

Accumulations of Igs in the cisternae

Answer 29

MOTT CELL, MORULA CELL or PLASMA CELL WITH RUSSELL BODIES

Question 30

intranuclear inclusions

Answer 30

DUTCHER BODIES –

Question 31

Circulating plasma cell levels > 2 X 109/L (0.14-0.20 NV)

Answer 31

PLASMA CELL LEUKEMIA

Question 32

PLASMA CELL LEUKEMIA

Answer 32

Younger patients Less bone pain Less osteolysis Greater incidence of lymphadenopathy and hepatosplenomegaly Pancytopenia with leukoerythroblastic findings Elevated ESR Abnormal plasma cells are smaller with little cytoplasm and pronounced N:C asynchronism BM infiltration is diffuse (45%)

Question 33

A lymphoproliferative disorder characterized by large concentrations of monoclonal IgM (>15%)

Answer 33

WALDENSTROM MACROGLOBULINEMIA

Question 34

The abnormal B lymphocytes arise from the extramedullary nodes and have the ability to differentiate to large plasmacytoid lymphocytes and plasma cells

Answer 34

WALDENSTROM MACROGLOBULINEMIA

Question 35

Rarely causes osteolytic lesions

Answer 35

WALDENSTROM MACROGLOBULINEMIA

Question 36

Glomerular lesions caused by deposition of IgM complexes of amyloid

Answer 36

WALDENSTROM MACROGLOBULINEMIA

Question 37

Affects men >50 years old with hepatosplenomegaly, lymphadenopathy and retinal abnormalities

Answer 37

WALDENSTROM MACROGLOBULINEMIA

Question 38

WALDENSTROM MACROGLOBULINEMIA LABORATORY FINDINGS

Answer 38

N/N Reticulocytes dec. or N Normal WBC and platelets BM- plasmacytoid lymphoma (+) Mast cells – CLUE!

Question 39

Autoimmune hemolytic anemia

Answer 39

Raynaud’s phenomenon (anti-G) Cold agglutinin (anti-i)

Question 40

WALDENSTROM MACROGLOBULINEMIA platelet function fibrinogen thrombin time plasma viscosity Monoclonal IgM with cryoglobulin activity

Answer 40

Abnormal platelet function Thrombocytosis (maybe plasma precipitates) Low fibrinogen Prolonged thrombin time Increased plasma viscosity – precipitation or gel formation at 4C Electrophoresis

Question 41

A rare disease characterized by abnormal synthesis of Fc fragment of a particular H chain particularly a (most common), g and m

Answer 41

HEAVY CHAIN DISEASE

Question 42

Resembles activated lymphocytes and plasma cell | Lymphoma like symptoms

Answer 42

HEAVY CHAIN DISEASE

Question 43

HCD characterized by infiltration of plasmacytoid lymphocytes into the duodenal and jejunal walls producing malabsorption and abdominal distress and respiratory tracts

Answer 43

ALPHA HCD

Question 44

HCD Found in older men and presents with a malignant lymphoma with fever, erythema, lymphadenopathy and hepatosplenomegaly

Answer 44

GAMMA HCD

Question 45

HCD Rarest; associated with CLL

Answer 45

MU HCD

Question 46

A condition in which proetinaceous deposits (amyloid) occur throughout the body

Answer 46

AMYLOIDOSIS

Question 47

closely associated with monoclonal gammopathies such as plasma cell myeloma

Answer 47

PRIMARY AMYLOIDOSIS

Question 48

associated with chronic illnesses and amyloid unrelated to Ig

Answer 48

SECONDARY AMYLOIDOSIS

Question 49

AMY Electron microscopy and Xray diffraction

Answer 49

amyloid is in the Beta pleated sheet formation

Question 50

AMY Polarizing microscopy with Congo red

Answer 50

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