203 Immunology and Inflammatory Joint Disease Diagnosis Tutorial

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What is the key aim of this tutorial based on the text?

To consider the presentation of inflammatory joint disease

Which of the following is NOT a learning objective mentioned in the text?

Draw a diagram of an ELISA experiment

What term is used to describe inflammation of only one joint in the text?


Based on the text, what are the presenting features of acute inflammation in the knee?

Heat, swelling, redness, pain

What is the significance of a positive CCP antibody mentioned in the text?

It confirms the presence of rheumatoid arthritis

Which of the following is NOT listed as a learning objective in the text?

Discuss the significance of positive RF antibody

'Acute monoarthritis' refers to inflammation in how many joints?

One joint

Which condition can cause monoarthritis in young adults and is characterized by the presence of fever or systemic upset?

Septic arthritis

Which condition can lead to monoarthritis in individual with a history of trauma or clotting disorder?


What is a distinguishing factor of sarcoidosis compared to other conditions in terms of monoarthritis?

Rare, and includes features such as skin rashes, raised bumps on the skin, joint pain or stiffness, and blurry vision.

Which condition, despite being uncommon, may present with monoarthritis and is typically seen in very young individuals?


Which type of arthritis typically presents with joint pain in young women and requires a history of psoriasis for diagnosis?

Psoriatic arthritis

What distinguishes crystal arthropathy from other causes of monoarthritis?

Usually present in the older population and has other risk factors such as previous surgery inherited genetic disorder, high levels of calcium or iron in the blood etc.

What key characteristic is often seen in cases of acute osteoarthritis that helps differentiate it from other forms of joint disorders?

Occurs primarily in the elderly population

What is a common feature of rheumatoid arthritis that distinguishes it from other arthritic conditions?

History of joint pain and often involves multiple joints, especially in young people

What is the significance of all controls falling within the expected range in the context of the assay results?

It indicates that the assay is technically valid.

What does an optical density of 0.576 for the patient's sample well suggest?

The patient's sample contains low levels of CCP antibodies.

Why is it important to consider the full clinical picture and other test results in the context of interpreting CCP antibody concentration?

To evaluate if the patient truly has rheumatoid arthritis.

What does a CCP antibody concentration of 103.05 U/ml indicate in the patient's sample?

A positive result for rheumatoid arthritis.

Why is it stated that immunomodulation should be started before joint damage occurs?

To limit the progression of rheumatoid arthritis.

In what scenario should a patient with monoarthritis and positive CCP antibody be referred urgently to Rheumatology?

If they have positive CCP antibody and joint inflammation.

Why is it mentioned that the presentation with monoarthritis is a bit unusual in this context?

To stress the importance of considering other clinical aspects in diagnosis.

What action should be taken if a control sample fails to fall within an acceptable range during the assay?

'Investigation' should be prompted to determine the validity of the assay.

Select the correct order of the KEY steps in the ELISA assay from this point

  1. Coat the well with Antigen, 2) Specific Antibody binds to the antigen, 3) Enzyme-linked antibody binds to the specific antibody, 4) Substrate is added and converted by enzyme into the coloured product; the rate of the colour formation is proportional to the amount of the specific antibody.

What is the purpose of the cyclic citrullinated peptide antibody (CCP antibody) test mentioned in the text?

To predict the likelihood of developing rheumatoid arthritis

What is the significance of the ELISA plate being pre-coated with CCP antigen and 'blocked' as mentioned in the text?

To standardize the procedure for all samples

Why is it important to run the sample in duplicate on a 96 well ELISA plate?

To compare results and ensure accuracy

What is the role of controls in an ELISA experiment as described in the text?

To provide baseline values for comparison

How does an optical density reading contribute to deriving CCP antibody concentration, as outlined in the text?

By providing a quantitative measure of antibody binding in the ELISA assay

This tutorial focuses on the clinical and laboratory diagnosis of joint pain in patients, with a specific emphasis on immunoassay methodology and inflammatory joint disease. Participants are required to complete a virtual ELISA exercise prior to the session. Group review of answers will be conducted after 20 minutes.

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