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Immunology And Serology BOARD EXAM > 27-28th Page > Flashcards

27-28th Page Flashcards

1
Q

What do treponemal tests detect?

A

Detect antibodies directed against the T. pallidum organism or against specific treponemal antigens.

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2
Q

Are treponemal tests easy to perform?

A

No, treponemal tests are more difficult to perform and time-consuming.

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3
Q

What type of antibodies are predominantly found in early or untreated early latent syphilis?

A

predominantly IgM antibodies.

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4
Q

What follows the early immune response to T. pallidum infection?

A

ppearance of IgG antibodies, which soon become predominant.

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5
Q

When is the greatest elevation in IgG concentration seen?

A

in secondary syphilis.

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6
Q

What is the Treponema Pallidum Immobilization Test (TPI)?

A

The TPI uses patient serum with live, actively motile T. pallidum extracted from testicular chancre of rabbit and complement.

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7
Q

positive TPI

A

Positive: >50% of treponemes are immobilized.

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8
Q

negative TPI

A

Negative: If fewer than 20% are immobilized.

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9
Q

doubtful TPI

A

Doubtful: Ranges 20 - 50% are immobilized.

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10
Q

What is the principle of the Fluorescent Treponemal Antibody Absorption Test (FTA-ABS)?

FId

A

indirect immunofluorescence

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11
Q

What is nonpathogenic treponemes in FTA-ABS

A

Reiter

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12
Q

What happens to the patient serum in the FTA-ABS test?

A

The patient serum is heat-inactivated and treated with a sorbent to remove cross-reactivity with treponemes other than T. pallidum.

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13
Q

How is the intensity of fluorescence reported in the FTA-ABS test?

A

green color is reported on a scale of 0 to 4.

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14
Q

reactive FTA-ABS

A

Reactive: 2+ to 4+.

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15
Q

negative FTA-ABS

A

Negative: No fluorescence.

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16
Q

FTA-ABS test is minimally reactive

A

If minimally reactive (1+), the test must be repeated with a second specimen drawn in 1 to 2 weeks.

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17
Q

what strain of T.pallidum is fixed to slides that is used for the test?

A

Nichol

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18
Q

TPHA test (TPHA (T. pallidum hemagglutination assay)

A

uses tanned sheep RBCs coated with antigen from the Nichols strain.

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19
Q

TAPA test? TAPA (T. pallidum particle agglutination assay)

A

uses gel particles sensitized with T. pallidum sonicate.

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20
Q

MHA-TP (micro hemagglutination assay for T. pallidum)

A

using formalinized, tanned sheep RBCs sensitized with antigen from the Nichols strain.

performed using microtiter plates

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21
Q

HATTS (Hemagglutination Treponemal test for Syphilis)

A

using glutaraldehyde stabilized turkey RBC.

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22
Q

What is the MONOSPOT TEST?

A

A rapid differential slide test that uses horse RBCs as an indicator.

More sensitive compared to the Davidson differential test.

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23
Q

positive result in the MONOSPOT TEST?

A

Dark clumps against a blue-green background, distributed uniformly throughout the test circle.

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24
Q

negative result in the MONOSPOT TEST?

A

No agglutination but may have fine granularity against a brown-tan background.

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25
Q

What is MONOTEST?

A

A test using ox hemolysin with ox RBCs and classical methods like 2% sheep RBCs.

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26
Q

What is the role of papain in the MONOTEST?

A

Papain destroys IM receptors and treated Sheep RBCs

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27
Q

Anti-VCA?

A

Produced by infected B cells and found in the cytoplasm,

Can persist for life.

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28
Q

detectable early in infection, but low conc. and disappears within 2 to 4 months.

A

Anti-VCA IgM

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29
Q

Where is Anti-EA found?

A

In the nucleus and cytoplasm of B cells, strongly indicating active infection.

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30
Q

What is Anti-EBNA?

A

Found in the nucleus of all EBV-infected cells

absent or barely detectable during acute IM.

Anti-EBNA IgG appears during the convalescent period.

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31
Q

EBV-Associated IM in the acute phase (0-3 months)?

A

Specific:
VCA IgM: Pos,
VCA IgG: Po
EA (D or R): Pos/Neg
EBNA: Neg.

Non-specific:
Heterophile IgM: Pos

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32
Q

EBV-Associated IM in the recent phase (3-12 months)?

A

Specific:
VCA IgM: Pos
VCA IgG: Pos
EA (D or R): Pos/Neg
EBNA: Pos.

Non-specific:
Heterophile IgM: Neg

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33
Q

EBV-Associated IM in the past phase (>12 months)?

A

Specific:
VCA IgM: Neg
VCA IgG: Pos
EA (D or R): Neg
EBNA: Pos.

Non-specific:
Heterophile IgM: Neg

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34
Q

What is infectious mononucleosis?

A

An acute infectious disease of the Reticuloendothelial system caused by EBV.

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35
Q

What are the target cells for infectious mononucleosis?

A

C3d receptor (CD21).

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36
Q

Kissing dse or Glandular fever

A

Infectious Mononucleosis

37
Q

What is the mode of transmission for infectious mononucleosis?

A

Intimate contact with salivary secretion from an infected individual.

38
Q

What are the manifestations of infectious mononucleosis?

A

High WBC count (leukocytosis);
Differential count (>50% lymphocytes);
Increased WBC with >10% atypical lymphocytes (Downey cells);
Presence of heterophile antibodies.

39
Q

What is significant about heterophile antibodies in serologic tests of IM?

A

A titer of 1:56 or greater is clinically significant in patients with suspected infectious mononucleosis.

40
Q

What is a titer?

A

The highest dilution of serum that still shows a positive result.

41
Q

What is the Paul-Bunnel test?

A

A screening test/ presumptive hemagglutination test that measures total heterophile antibodies using sheep RBCs.

42
Q

What does the presence of agglutination in the Paul-Bunnel test indicate?

A

A positive reaction of heterophile antibodies.

43
Q

What types of heterophile antibodies can be detected if there is agglutination?

A
  1. Antibodies to Forsmann antigen
  2. Antibodies in serum sickness
  3. Antibodies in infectious mononucleosis.
44
Q

What is the Davidsohn differential test?

A

A test that involves adsorption with guinea pig cells, beef and Ox RBCs to differentiate types of heterophile antibodies.

45
Q

What are the steps in the Davidsohn differential test?

A
  1. Adsorption
  2. Addition of indicator cells (Sheep RBCs)
  3. Interpretation for agglutination with sheep RBC
46
Q

What is Hepatitis?

A

Inflammation of the liver.

47
Q

What is Falminant Hepatitis?

A

Term applied when the number of hepatocytes destroyed is so few that they cannot maintain basic liver function.

48
Q

What is Hepatitis A (HAV)?

A

Non-enveloped, icosahedral, ssRNA virus from the family PicoRNAviridae.

49
Q

What is the mode of transmission (MOT) for Hepatitis A?

A

Fecal-oral.

50
Q

What are the diagnostic markers for Hepatitis A?

A

HAV Ag and Anti-HAV antibodies.

51
Q

What specimen is used to detect HAV Ag?

A

Stool.

52
Q

What specimen is used to detect Anti-HAV?

A

Serum.

53
Q

What is Hepatitis B (HBV)?

A

A virus from the family Hepadnaviridae (dsDNA) that exists in three forms: spherical particle, filamentous form, and Dane particle.

54
Q

What is the mode of transmission (MOT) for Hepatitis B?

A

Parenteral, sexual, perinatal.

55
Q

What are the HBV markers?

A

HBSAg
HBeAg
HBcAg

56
Q

What is the earliest detectable HBV marker?

A

HBsAg.

57
Q

What is the lifelong marker antibodies for HBV?

A

Anti-HBc.

58
Q

What does the presence of Anti-HBc IgM indicate?

A

Acute phase marker.

59
Q

What does the presence of Anti-HBc IgG indicate?

A

Chronic phase marker

60
Q

Dane particle?

A

It represents the virion and is seen in blood, semen, urine, colostrum, and other body fluids.

61
Q

What is the mortality rate associated with chronic Hepatitis B?

A

Less than 1.2%.

62
Q

How many % in chronic hepatitis (HBV)

A

5-1%

63
Q

Anti-EA found in nucleus and cytoplasm of B cells

A

EA-D

64
Q

Found as a mass only in cytoplasm

A

EA-R

65
Q

Does not appear until a px has entered the convalescent period

A

Anti-EBNA IgG

66
Q

What RBC is used in Paul-Bunnel Test

A

Sheep RBC

67
Q

Ab produced by one species and can infect other species

A

Heterophile Ab

68
Q

In Paul-Bunnel Test, serum is serially diluted

A

TRUE

69
Q

Endpoint titer in Paul-Bunnel

A

1:56

70
Q

IM, Serum sickness, Forssman-induced

Sheep
Horse

A

Are all +

71
Q

The only source of Ab with negative Beef RBC

A

Forssman-induced

72
Q

The only source of Ab with negative guinea pig kidney

A

IM

73
Q

Where are HAV located

A

primarily in cytoplasm of liver where it multiplies easily

74
Q

Infectious Hepatitis/ Short Incubation hepatitis

A

HAV

75
Q

More common in countries with low standard’s of living

A

Poorman’s hepatitis

76
Q

Marker of Acute Hepatitis A

A

IgM anti-HAV

peaks during 1st month of illness

77
Q

produced as a result of natural infection or immunization

A

IgG anti-HAV

78
Q

predominant form seen in blood in dsDNA (HBV)

A

Spherical

79
Q

Slightly less common in dsDNA (HBV)

A

Filamentous

80
Q

represents the virion (least common)

A

Dane particle

81
Q

Serum hepatitis/ Long-incubation hepatitis

A

HBV

82
Q

Antigens of high infectivity, high vertical transmission

A

HBeAg

83
Q

Antigens not found in blood (only infected hepatocytes)

A

HBcAg

84
Q

Liver FNAB

A

HBcAg

84
Q

The only antibody detected in window phase

A

Anti-HBc

85
Q

Low infectivity marker (Low MOT)

Convalescence

A

Anti-HBe

86
Q

Ab last to appear

A

Anti-HBS

87
Q

Immune state marker

A

Anti-HBS

Immunology And Serology BOARD EXAM (32 decks)

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