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2 short case studies see the attachments
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CASE 2
A 23-year-old female patient was complaining of joint pain throughout her body. The
patient also presented with a rash on their face. Fluorescent antinuclear antibody
(FANA) testing indicated positive fluorescence with a speckled pattern. Anti-rheumatoid
factor and anti-CCP testing both came back negative for the patient. It was later
confirmed by multiplex fluorescent microbead testing that the patient contained anti-Sm,
anti-DNP and anti-RNP antibodies.
1. Which autoimmune disease the patient most likely have? (1 pt)
2. What type of hypersensitivity can this disease induce? Briefly explain your
answer (2 pts)
3. Which specific HLA allele is commonly associated in patients with this disease?
(1 pt)
4. Could the FANA testing results ALONE be enough to CONFIRM this disease you
answered in question #11? Explain your answer regarding the sensitivity and
specificity of FANA testing. (3 pts)
5. Explain the principle of multiplexed fluorescent microbead (microsphere multiplex
immunoassay (MIA)) test (i.e what is the analyte, how does this assay detect the
analyte). (3 pts)
CASE 1
A 7-year old male was stung by a bee at school during recess. Minutes later he had a hard time
breathing, and presented with rapid swelling of the throat are. They immediately got him to the school
nurse, where his blood pressure was well below normal. The nurse immediately injected a shot of
epinephrine, and symptoms started to subside.
1. What type of hypersensitivity (1,2,3 or 4) BEST describes this case? (1 pt)
2. Which immunoglobulin isotype AND cell are involved in this type of
hypersensitivity? (2 pts)
3. Name 2 compounds (mediators) that are immediately released from Mast cells
that induce this type of hypersensitivity. (2 pts)
4. Indicate 1 compound (mediator) that is synthesized by mast cells during the late
phase of this hypersensitivity reaction. (1 pt)
5. Explain the action mechanism of epinephrine. ( 2 pts)
6. Which 2 WBC’s may be increased during this allergic reaction? (2 pts)
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