Clinical Microbiology and Immunology term paper

Marks for part questions are as indicated (-), all sections questions equally
weighed and are out of 100 marks total. Pay attention to the marks for each
question and make sure your answers length equates to the mark given.

Word limits and referencing, Harvard style, expectations are provided for
guidance where relevant.
   

For the case study in Section A, please answer the questions precisely and
concisely. Make sure to check the instructions of the questions and do as
indicated. Your answer should be maximum 300 words.   

For Sections B and C, the word count should be between 600 and 750 words.  
Section A: Case Study (300 word limit)

1.
a) Identify and comment on the blood group and antibody panel reactions
provided. Annotate the panel to show your workings and explain the
difference between AHG (Anti-human globin) and ENZ (Enzyme or Papain)
panel reactions. (40 marks)

Forward Group Reverse Group

Anti-A Anti-B Anti-D Control A1 cells B cells

0 4+ 4+ 4+ 4+ 0
b) The results in part 1a are part of an investigation of a 27-year-old female who
has severe sickle-cell disease and has just delivered her second baby.
Discuss the possible causes for this case of haemolytic disease of the
newborn (HDFN) and the relevant laboratory tests used to investigate HDFN.
(60 marks)
Section B: Immunology (600 – 750 word limit)

1. The figure below shows the analysis of CD4+ T cells activation in response to
SEB.

A. Clearly referring to the data shown, explain why each of the following
statements is true or false: (25 marks)

I. After SEB stimulation, the frequency of IFNγ and TNFα double positive T
cells is not affected by IL-7.

II. Both unstimulated and SEB-stimulated cells are tested for cytokine
expression by ICS assay.

III. The frequency of CD127 positive T cells is not greatly affected by IL-7
stimulation

IV. SEB activates all T cells, independently of their antigen specificity.

 B. How can Superantigens cause systemic toxicity? Briefly present one example
of a clinical condition caused by superantigens. (40 marks)

C. Activation of immunity can be tested by the level of cytokines secreted by

cells and measured by Elispot, ICS (Intracellular Cytokine Staining) or ELISA.
Briefly explain which of these assays can measure the frequency of activated
cytokine-secreting cells at single-cell level. (20 marks)

Briefly describe one unique advantage of each assay. (15 marks)

ELISPOT ICS ELISA

Briefly explain if the

assay can measure
the frequency of
activated cytokine-
secreting cells at
single-cell level

Briefly describe one

unique advantage of
each assay
Section C: Microbiology (600 – 750 word limit)

3.
A. Outline the pathophysiology of botulism. (40marks)

B. How does classification of the toxin help elucidate the pathophysiology of the
disease? (40 marks)

C. What is the considered the most important determinant of the outcome in

treating the disease? How does this relate to your understanding of the
pathophysiology of the disease? (20 marks)